The purpose of this study is to compare the anesthetic effect of oxalidine and sufentanil in strabismus surgery through a non inferiority test, including analgesic efficacy, intraoperative hemodynamic stability, postoperative recovery quality and the incidence of adverse reactions. . This study will provide a new evidence-based basis for the application of opioids in ophthalmic short surgery, and may improve the perioperative experience of patients.
Since surgery involves fine manipulation of the ocular muscles, postoperative pain and oculocardiac reflex (OCR) are common clinical challenges. Therefore, anesthesia management should not only ensure adequate analgesia, but also minimize stress reactions and adverse reactions caused by surgical stimuli. At present, opioids such as sufentanil are widely used in the anesthesia scheme of such surgery because of its potent analgesia and stable hemodynamic characteristics. However, sufentanil may cause respiratory depression, postoperative nausea and vomiting (PONV) and other side effects, and its high lipid solubility may prolong the postoperative recovery time. Oliceridine is a new selective μ - opioid receptor agonist. Compared with traditional opioids, it has the characteristics of biased activation of G protein pathway, which may provide effective analgesia and reduce the adverse reactions mediated by β - arrestin pathway (such as respiratory depression and gastrointestinal dysfunction). Recent studies have shown that oselidine has shown good safety and efficacy in postoperative analgesia, but its application in short ophthalmic surgery (such as strabismus correction) has not been fully explored.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
290
After entering the room, the patient was intravenously injected with oselidine at a dose of 0.08mg/kg during anesthesia induction
After the patient entered the room, sufentanil was injected intravenously during anesthesia induction with a dose of 0.4 μ g/kg
Adequate rate of intraoperative analgesia
Definition: No body movement (body movement score ≤ 1) and no need for additional analgesics during surgical skin cutting and eye muscle traction. Evaluation method: Physical activity score (0-3 points): 0=none; 1=Mild (does not interfere with surgery); 2=Obvious (requiring intervention); 3=Severe (pause surgery).
Time frame: From enrollment to the end of treatment at 1 day
Success rate of initial insertion of laryngeal mask
One time insertion of laryngeal mask without adjustment/replacement, and good airway sealing (normal ETCO ₂ waveform)
Time frame: From enrollment to the end of treatment at 1 day
Ocular Heart Reflex (OCR) incidence rate
HR decline\>20% may require atropine intervention.
Time frame: From enrollment to the end of treatment at 1 day
Hemodynamic fluctuations
Hypotension (MAP\<65 mmHg or decrease from baseline\>30%), hypertension (MAP\>100 mmHg)
Time frame: From enrollment to the end of treatment at 1 day
Respiratory inhibition:
SpO ₂\<90% or ETCO ₂\>50 mmHg
Time frame: From enrollment to the end of treatment at 1 day
Postoperative nausea and vomiting (PONV) (0-24h)
Rating: 0=none; 1=Mild (no need for treatment); 2=Moderate (requires antiemetic medication); 3=Severe (repeated vomiting)
Time frame: From enrollment to the end of treatment at 1 day
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