Anaesthesia for ophthalmic surgery

2017 ◽  
Author(s):  
Chris Dodds ◽  
Chandra M. Kumar
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
The Elderly ◽  
Ophthalmic Surgery ◽  
Ophthalmic Drugs ◽  
Minor Surgery ◽  
Multiple Drugs ◽  
Current Preference

Anaesthesia for ophthalmic surgery has always been challenging because the patients range across all ages, but the elderly are especially vulnerable. They have an increased morbidity and are often taking multiple drugs that make even anaesthesia for minor surgery more risky. No wonder there has been a shift in the delivery of anaesthesia towards regional techniques although general anaesthesia remains the technique of choice for many intermediate and most complex ophthalmic operations. Understanding the physiology of the eye, the relevant anatomy, and the ophthalmic drugs patients may receive, all have major influences on the choice of anaesthesia. This varies worldwide but the current preference is firmly in favour of local anaesthesia. A practising ophthalmic anaesthetist should be skilled in a range of different techniques to deal with the needs of different operations, operators, and, most importantly, patients.

Ophthalmic anaesthesia

2014 ◽  
Author(s):  
Jeremy Prout ◽  
Tanya Jones ◽  
Daniel Martin
Keyword(s):  
Special Reference ◽  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Perioperative Management ◽  
The Elderly ◽  
Eye Injury ◽  
Physiological Control ◽  
Intra Ocular Pressure ◽  
Penetrating Eye Injury ◽  
Ocular Pressure

This chapter covers the considerations for pre-assessment in ophthalmic patients with special reference to the elderly and paediatric populations and factors that influence the choice of anaesthetic technique. Local anaesthesia options are described with conduct of subTenons and peribulbar blocks, benefits and complications. General anaesthesia is discussed with special reference to paediatric patients and circumstances such as penetrating eye injury. Perioperative management may require drugs that influence intra-ocular pressure and the physiological control of intra-ocular pressure is explained.

scholarly journals Thyroidectomy under Local Anaesthesia; Experience from a Tertiary Hospital in Kumasi, Ghana

2020 ◽  
Vol 2 (2) ◽  
pp. 01-07
Author(s):  
Anna Konney ◽  
Mawutor Dzogbefia ◽  
Philip Oppong Peprah ◽  
Derrick Gyimah ◽  
Isaac Barnor
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Operating Time ◽  
Cost Effective ◽  
Tertiary Hospital ◽  
Tertiary Referral Hospital ◽  
Thyroid Lobectomy ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
The Cost

Objectives: Improvement in anaesthesia has allowed thyroidectomies to be performed mainly under general anaesthesia. There is however a growing interest in performing thyroid surgery under local or regional anaesthesia. The objective of this study was to analyse and share our experience with safety of thyroidectomy under regional cervical plexus block/ local anaesthesia in a tertiary referral hospital in Ghana. Materials and Methods: A retrospective study was conducted on all patients who had thyroidectomy under local anaesthesia from 1st January 2017 to 31st May 2018 in KATH. Data collected were demography, grade of goitre, operating time, and duration of hospital stay, complications and cost effectiveness of the procedure. Data was analysed using Stata version 16.0software. Results: A total of 105 thyroidectomies were done in the study period out of which 16 were done under local anaesthesia. All 16 patients (16 females, 100%) and majority 11 (68.75%) were aged between 30 and 50 years. 11 (68.75) had grade IB goitres. The most frequently performed surgery was thyroid lobectomy 12 (75%) and in 75% of cases the surgery was completed between 60 and 90 minutes. Most patients, 9 (56.25%) were discharged home within 48 hours following surgery. The cost of treatment was averagely 30% less compared to same surgery under general anaesthesia. No complications were recorded in the post-operative period. Conclusions: Comprehensive clinical assessment and careful patient selection for thyroidectomy under local anaesthesia result in good surgical outcomes. The procedure is safe and cost-effective and should be performed by experienced surgeons for the best outcomes.

Design and clinical application of the ‘styloidectome’ styloid process cutter

2006 ◽  
Vol 120 (9) ◽  
pp. 753-758 ◽  
Author(s):  
W Zhibin ◽  
J Min
Keyword(s):  
Blood Loss ◽  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Styloid Process ◽  
Morphological Data ◽  
Clinical Use ◽  
Deep Tissue ◽  
Tissue Space ◽  
Oral Approach ◽  
The Individual

A styloid process (SP) cutter was developed and put into clinical use. The design of components of the ‘styloidectome’ was based on the principles of mechanics. The measurements of the individual parts were determined on the basis of morphological data of the oropharynx from 40 subjects undergoing tonsillectomy under general anaesthesia. Experiments showed that the instrument could be used to transect the SP and excise the amputated bones from the deep tissue space. We used the instrument for the resection of elongated SPs, via an oral approach, in seven in-patients (involving 10 SPs) under general anaesthesia and in two out-patients (involving three SPs) under local anaesthesia. The length of the resected SP ranged from 0.8 to 2.5 cm and the stump of the SP was smooth. The removal lasted only seconds and blood loss was minimal, without any complications. The styloidectome was reliable, easy to use and could be used for the resection of an elongated SP under general or local anaesthesia.

scholarly journals Gastro-Oesophageal Reflux and Adverse Respiratory Events in Children under Anaesthesia

1995 ◽  
Vol 23 (5) ◽  
pp. 587-590 ◽  
Author(s):  
J. G. Milross ◽  
B. H. Negus ◽  
N. E. Street ◽  
K. J. Gaskin
Keyword(s):  
General Anaesthesia ◽  
Ph Monitoring ◽  
Acid Reflux ◽  
Oesophageal Reflux ◽  
Respiratory Events ◽  
Respiratory Event ◽  
Class 1 ◽  
Minor Surgery ◽  
Adverse Respiratory Event ◽  
Adverse Respiratory Events

The incidence of gastro-oesophageal reflux in children undergoing general anaesthesia has not previously been studied. One-hundred-and-twenty children (ASA Class 1–2) were studied intraoperatively using continuous oesophageal pH monitoring. The incidence of reflux was 2.5% (3 of 120). None of these three patients had an adverse respiratory event. There was no correlation between reflux and adverse respiratory events. Thirteen patients had minor respiratory events without evidence of acid reflux. Gastro-oesophageal reflux does occur in healthy paediatric patients having minor surgery, but was not a significant cause of the adverse respiratory events that occurred in our study.

scholarly journals Impact of economic crisis on indications for general versus local anaesthesia in head and neck surgery: a single centre analysis

2014 ◽  
Vol 3 (6) ◽  
pp. 92
Author(s):  
Tatjana Goranovic ◽  
Boris Simunjak ◽  
Dinko Tonkovic ◽  
Miran Martinac
Keyword(s):  
Cost Saving ◽  
Head And Neck ◽  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Significant Difference ◽  
Before And After ◽  
Saving Measure ◽  
The Impact

Objective: To analyze the impact of the hospital board’s cost saving measure on physicians’ decision to indicate head and neck surgery according to the type of anaesthesia (general versus local). Methods: Design: a retrospective analysis of medical charts on head and neck surgery and anaesthesia covering 2011-2012. Setting: department of otorhinolaryngology and head and neck surgery, university hospital, Croatia. Participants: patients undergoing head and neck surgery. Intervention(s): reduction of departmental financial fund for general anaesthesia for 10%. Main Outcome Measure(s): an overall of number of head and neck surgeries performed in general versus local anaesthesia before and after the implementation of the intervention measure. Results: There were a total of 984 head and neck surgeries in general anaesthesia in 2011 and 861 in 2012. There were a total of 460 head and neck surgeries in local anaesthesia in 2011 and 528 in 2012. The performance of head and neck surgeries in general anaesthesia was significantly reduced in a year after the implementation of the intervention (p = .01) There was no statistical significant difference in the performance of head and neck surgeries in local anaesthesia before and after the intervention. Conclusions: The reduction of departmental fund for general anaesthesia as a cost saving method resulted only in reducing the total performance of surgeries in general anaesthesia without any switch to performing surgeries in local anaesthesia. It seems that the hospital board’s cost saving measure did not have any impact on physicians’ decisions to indicate more surgeries in local anaesthesia. 

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