Study on the Effect and Correlation of Muscle Relaxants on the Eye Posi-tion of Children Undergoing Exotropia-Correcting Surgery under General Anesthesia
Objective To investigate the effect and correlation of muscle relaxants on the eye position of children un-dergoing exotropia-correcting surgery under general anesthesia.Methods A total of 80 children with exotropia admitted from September 2021 to December 2023 were selected and underwent elective exotropia-correcting surgery under general anesthesia.They were divided into the observation group(n=40)and a control group(n=40)according to random number table meth-od.The control group received conventional anesthesia induction without muscle relaxant,while the observation group received muscle relaxants(Benzylpenicillin for injection)on the basis of the control group.The eye position scores were compared be-tween the two groups before anesthesia induction(T0),immediately after anesthesia induction(T1),during the shallow an-esthesia period under bispectral index(BIS)monitoring(T2),and during the deep anesthesia period under BIS monitoring(T3).The correlation between muscle relaxants and the change in eye position of children,as well as the correlation between BIS values and the degree of change in eye position(eye position score)of children,were analyzed.The mean arterial pres-sure(MAP),heart rate(HR),quality of recovery,use of atropine,and adverse reactions at T0-T3,as well as strabismus degree,fusion range,and quality of life before surgery and at 3 month after surgery were compared between the two groups.Results The eye position scores at T1,T2,and T3 in the observation group were lower than those in the control group(P<0.01).The proportion of eye position elevated during general anesthesia in the observation group was lower than that in the control group(P<0.05).The risk of elevated eye position in children who used muscle relaxants was lower than that in chil-dren who did not use muscle relaxants(RR=5.000,95％CI:1.169,21.391).The BIS value was positively correlated with the eye position score of children undergoing exotropia-correcting surgery under general anesthesia(r=0.781,P<0.05).MAP and HR at T1,T2,and T3 in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the time from drug withdrawal to spontaneous breathing recovery,the time to recovery,and the time from the end of surgery to discharge between the two groups(P>0.05).The proportion of Atropine use in the observation group was lower than that in the control group(P<0.05).The incidence of coughing and body movement in the observation group was 2.50％and5.00％,respectively,which was lower than that in the control group(20.00％and27.50％,respec-tively)(P<0.05).The degree of exotropia in the observation group was lower than that in the control group at3 months after surgery,while the fusion range and the score of quality of life scale the strabismus children were higher than those in the con-trol group(P<0.01).Conclusion The use of muscle relaxants during anesthesia induction in children undergoing exotropia-correcting surgery under general anesthesia can effectively stabilize hemodynamic levels,reduce the use of Atropine,reduce the risk of eye position elevation,and ensure surgical efficacy and anesthesia safety.
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