一期可调性斜视手术中增强意识镇静效果的前瞻性纵向研究。

IF 1.8 4区 医学 Q2 OPHTHALMOLOGY
Indian Journal of Ophthalmology Pub Date : 2025-09-01 Epub Date: 2025-07-18 DOI:10.4103/IJO.IJO_2624_24
Ishwarya M Anandhi, Muralidhar Rajamani, S Hemamalini, P Chidambaram, Sekar Michael, D Ramamurthy
{"title":"一期可调性斜视手术中增强意识镇静效果的前瞻性纵向研究。","authors":"Ishwarya M Anandhi, Muralidhar Rajamani, S Hemamalini, P Chidambaram, Sekar Michael, D Ramamurthy","doi":"10.4103/IJO.IJO_2624_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Adjustable strabismus surgery offers surgeons the flexibility to refine outcomes postoperatively, with single-stage adjustable strabismus surgery (SSASS) allowing immediate adjustments facilitated by intravenous fentanyl and midazolam.</p><p><strong>Purpose: </strong>Our study aims to study the efficacy of a specific drug combination for SSASS.</p><p><strong>Methods: </strong>This prospective study enrolled 32 participants aged 14 years and older undergoing horizontal or inferior rectus muscle surgeries under anesthetist supervision. Premedication with ondansetron, glycopyrrolate, dexamethasone, tramadol, and ketorolac was done with sedation maintained using midazolam and fentanyl. Strabismus surgeries were conducted with monitoring of vital signs and hemodynamic parameters. Postoperative assessments were performed for one day and one month.</p><p><strong>Results: </strong>Mean surgery duration was 1.1 ± 0.3 hours, with favorable mean intraoperative pain scores of 1.34 ± 0.9 and postoperative pain scores of 1.6 ± 0.9. No significant changes in hemodynamic parameters or postoperative vomiting were observed. However, substantial exotropic drift reduced success rates to 87.5% on the first postoperative day and 78.1% at one month.</p><p><strong>Conclusion: </strong>Our findings demonstrate effective analgesia, hemodynamic stability, and surgeon comfort during SSASS with the studied drug combination. Ketorolac likely contributed to low postoperative pain scores, enabling conservative fentanyl dosing. Despite initial success in alignment, exotropic drift challenges long-term outcomes, suggesting a need for revised target angles in future studies to improve results.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"1330-1337"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448506/pdf/","citationCount":"0","resultStr":"{\"title\":\"A prospective longitudinal study on the outcome of augmented conscious sedation in single-stage adjustable strabismus surgery.\",\"authors\":\"Ishwarya M Anandhi, Muralidhar Rajamani, S Hemamalini, P Chidambaram, Sekar Michael, D Ramamurthy\",\"doi\":\"10.4103/IJO.IJO_2624_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Adjustable strabismus surgery offers surgeons the flexibility to refine outcomes postoperatively, with single-stage adjustable strabismus surgery (SSASS) allowing immediate adjustments facilitated by intravenous fentanyl and midazolam.</p><p><strong>Purpose: </strong>Our study aims to study the efficacy of a specific drug combination for SSASS.</p><p><strong>Methods: </strong>This prospective study enrolled 32 participants aged 14 years and older undergoing horizontal or inferior rectus muscle surgeries under anesthetist supervision. Premedication with ondansetron, glycopyrrolate, dexamethasone, tramadol, and ketorolac was done with sedation maintained using midazolam and fentanyl. Strabismus surgeries were conducted with monitoring of vital signs and hemodynamic parameters. Postoperative assessments were performed for one day and one month.</p><p><strong>Results: </strong>Mean surgery duration was 1.1 ± 0.3 hours, with favorable mean intraoperative pain scores of 1.34 ± 0.9 and postoperative pain scores of 1.6 ± 0.9. No significant changes in hemodynamic parameters or postoperative vomiting were observed. However, substantial exotropic drift reduced success rates to 87.5% on the first postoperative day and 78.1% at one month.</p><p><strong>Conclusion: </strong>Our findings demonstrate effective analgesia, hemodynamic stability, and surgeon comfort during SSASS with the studied drug combination. Ketorolac likely contributed to low postoperative pain scores, enabling conservative fentanyl dosing. Despite initial success in alignment, exotropic drift challenges long-term outcomes, suggesting a need for revised target angles in future studies to improve results.</p>\",\"PeriodicalId\":13329,\"journal\":{\"name\":\"Indian Journal of Ophthalmology\",\"volume\":\" \",\"pages\":\"1330-1337\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448506/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/IJO.IJO_2624_24\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/IJO.IJO_2624_24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

可调性斜视手术为外科医生提供了改善术后结果的灵活性,单期可调性斜视手术(SSASS)允许通过静脉注射芬太尼和咪达唑仑进行即时调整。目的:我们的研究旨在研究一种特定的药物组合治疗SSASS的疗效。方法:这项前瞻性研究招募了32名年龄在14岁及以上的参与者,他们在麻醉师的监督下接受水平或下直肌手术。术前应用昂丹西琼、甘炔诺酸酯、地塞米松、曲马多和酮罗拉酸,镇静使用咪达唑仑和芬太尼。斜视手术时监测生命体征和血流动力学参数。术后评估分别为1天和1个月。结果:平均手术时间为1.1±0.3小时,术中疼痛评分为1.34±0.9,术后疼痛评分为1.6±0.9。血流动力学参数和术后呕吐均未见明显变化。然而,大量的外向漂移使术后第一天的成功率降至87.5%,一个月后的成功率降至78.1%。结论:我们的研究结果表明,在所研究的药物组合下,SSASS的镇痛效果、血流动力学稳定性和外科医生舒适度都很好。酮罗拉酸可能有助于降低术后疼痛评分,使芬太尼的保守剂量成为可能。尽管在对准方面取得了初步成功,但外源性漂移对长期结果提出了挑战,这表明需要在未来的研究中修改目标角度以改善结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A prospective longitudinal study on the outcome of augmented conscious sedation in single-stage adjustable strabismus surgery.

Introduction: Adjustable strabismus surgery offers surgeons the flexibility to refine outcomes postoperatively, with single-stage adjustable strabismus surgery (SSASS) allowing immediate adjustments facilitated by intravenous fentanyl and midazolam.

Purpose: Our study aims to study the efficacy of a specific drug combination for SSASS.

Methods: This prospective study enrolled 32 participants aged 14 years and older undergoing horizontal or inferior rectus muscle surgeries under anesthetist supervision. Premedication with ondansetron, glycopyrrolate, dexamethasone, tramadol, and ketorolac was done with sedation maintained using midazolam and fentanyl. Strabismus surgeries were conducted with monitoring of vital signs and hemodynamic parameters. Postoperative assessments were performed for one day and one month.

Results: Mean surgery duration was 1.1 ± 0.3 hours, with favorable mean intraoperative pain scores of 1.34 ± 0.9 and postoperative pain scores of 1.6 ± 0.9. No significant changes in hemodynamic parameters or postoperative vomiting were observed. However, substantial exotropic drift reduced success rates to 87.5% on the first postoperative day and 78.1% at one month.

Conclusion: Our findings demonstrate effective analgesia, hemodynamic stability, and surgeon comfort during SSASS with the studied drug combination. Ketorolac likely contributed to low postoperative pain scores, enabling conservative fentanyl dosing. Despite initial success in alignment, exotropic drift challenges long-term outcomes, suggesting a need for revised target angles in future studies to improve results.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.80
自引率
19.40%
发文量
1963
审稿时长
38 weeks
期刊介绍: Indian Journal of Ophthalmology covers clinical, experimental, basic science research and translational research studies related to medical, ethical and social issues in field of ophthalmology and vision science. Articles with clinical interest and implications will be given preference.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信