The Effect of Peribulbar Block with General Anesthesia for Vitreoretinal Surgery in Premature and Ex-Premature Infants with Retinopathy of Prematurity

2016 ◽  
Vol 6 (2) ◽  
pp. 25-27 ◽  
Author(s):  
Renu Sinha ◽  
Souvik Maitra
Keyword(s):  
General Anesthesia ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Vitreoretinal Surgery ◽  
Peribulbar Block

Choosing optimal anesthetic and method of general anesthesia for laser surgery retinopathy of prematurity

2021 ◽  
pp. 196-201
Author(s):  
S.I. Utkin ◽  
◽  
M.V. Stolyarov ◽  
D.Y. Ignatenko ◽  
E.A. Bachinin ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Laser Surgery ◽  
Breathing Circuit ◽  
Face Mask ◽  
Laser Coagulation ◽  
Efficacy And Safety ◽  
Continuous Sampling ◽  
Low Concentrations

Purpose. Comparative analysis of clinical efficacy and safety of inhalational general anesthesia (GA) with halothane and sevoflurane in premature infants with retinopathy of prematurity (ROP) during laser coagulation (LC) of the avascular retina. Material and methods. The clinical material included 284 children who underwent laser surgery of ROP in the period from 2008 to 2017 (method of continuous sampling). Introduction to anesthesia and maintenance of anesthesia was performed by inhalation of anesthetic (halothane or sevoflurane) with O2 using face mask and Mapleson breathing circuit. Two groups were formed: in the 1st group (167 people) halothane was used at anesthetic at oxygen concentration of 0.3 vol%, in the 2nd group (117 people) – sevoflurane at concentration of 1–1.5 vol%. Results. In case of GA with halothane in children of the 1st group, in 68 children (40.7%) developed negative reactions during anesthesia in the form of of respiratory depression, in several cases – up to pronounced bradypnea, bradycardia, prolonged awakening after surgery. In the 2nd group with GA with sevoflurane, negative reactions in the form of moderate bradycardia and bradypnea were observed only in 14 children (11.9%). All complications and reactions were promptly eliminated in all cases. Conclusion. Based on the obtained results, the optimal inhalation anesthetic for LC of retina in premature infants is sevoflurane in low concentrations (at the sedation level) using the Mapleson breathing circuit and face mask. With this method of anesthesia, the frequency of side effects of sevoflurane, negative reactions during anesthesia and the degree of their severity are extremely low. Key words: premature infants, retinopathy of premature, sevoflurane, general anesthesia, laser coagulation of the retina.

scholarly journals Identification of candidate genes and pathways in retinopathy of prematurity by whole exome sequencing of preterm infants enriched in phenotypic extremes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sang Jin Kim ◽  
◽  
Kemal Sonmez ◽  
Ryan Swan ◽  
J. Peter Campbell ◽  
...  
Keyword(s):  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Preterm Infants ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Smooth Endoplasmic Reticulum ◽  
Enrichment Analysis ◽  
Retinal Disease ◽  
Gene Set Enrichment Analysis ◽  
Whole Exome

AbstractRetinopathy of prematurity (ROP) is a vasoproliferative retinal disease affecting premature infants. In addition to prematurity itself and oxygen treatment, genetic factors have been suggested to predispose to ROP. We aimed to identify potentially pathogenic genes and biological pathways associated with ROP by analyzing variants from whole exome sequencing (WES) data of premature infants. As part of a multicenter ROP cohort study, 100 non-Hispanic Caucasian preterm infants enriched in phenotypic extremes were subjected to WES. Gene-based testing was done on coding nonsynonymous variants. Genes showing enrichment of qualifying variants in severe ROP compared to mild or no ROP from gene-based tests with adjustment for gestational age and birth weight were selected for gene set enrichment analysis (GSEA). Mean BW of included infants with pre-plus, type-1 or type 2 ROP including aggressive posterior ROP (n = 58) and mild or no ROP (n = 42) were 744 g and 995 g, respectively. No single genes reached genome-wide significance that could account for a severe phenotype. GSEA identified two significantly associated pathways (smooth endoplasmic reticulum and vitamin C metabolism) after correction for multiple tests. WES of premature infants revealed potential pathways that may be important in the pathogenesis of ROP and in further genetic studies.

Effects of Marginal Hypoxemia on Recovery from Oxygen-Induced Retinopathy in the Kitten Model

PEDIATRICS ◽  
1984 ◽  
Vol 73 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Dale L. Phelps ◽  
Arthur L. Rosenbaum
Keyword(s):  
Clinical Trials ◽  
Premature Infants ◽  
Vascular Injury ◽  
Retinopathy Of Prematurity ◽  
Oxygen Supplementation ◽  
Predictive Variable ◽  
Oxygen Induced Retinopathy ◽  
Oxygen Administration

Prolonged oxygen administration in premature infants is the most predictive variable for severe retinopathy of prematurity, after degree of prematurity itself. It was noted that infants receiving prolonged oxygen supplementation are probably hypoxemic relative to their healthy counterparts. Therefore, hypoxemia during recovery from a hyperoxic-induced retinal vascular injury was tested in the kitten model of oxygen-induced retinopathy. Twelve litters were exposed to 80% inspired O2 for 65 hours on day 3, and recovered in room air, 13% or 17% oxygen. The retinas were scored at 4 weeks, and 13% oxygen recovery (PO2 = 39 ± 18 torr) was found to worsen significantly the retinopathy compared with that in room air-recovered littermates (P < .01). Hemorrhages occurred more frequently in the retinas from the hypoxemic-recovered kittens. Clinical trials of this hypothesis are indicated in humans.

Comparing General Anesthesia with Preemptive IV Atropine vs General Anesthesia with Single Injection Peribulbar Block with Levobupivacaine 0.5% or Lidocaine 2% for Prevention of Oculocardiac Reflex in Children Undergoing Strabismus Surgery: Randomized Control Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hani Ali Ezzat ◽  
Galal Adel ElKady ◽  
Melad Ragaey Zekry ◽  
Dalia Ahmed Ibrahim ◽  
Abeer Sameer Salem
Keyword(s):  
General Anesthesia ◽  
General Anaesthesia ◽  
Pain Control ◽  
Strabismus Surgery ◽  
Minor Role ◽  
Oculocardiac Reflex ◽  
Post Operative Pain ◽  
Peribulbar Block ◽  
Successful Group ◽  
Clinically Significant

Abstract Background Strabismus is one of the common health problems among the children. The incidence of the oculocardiac reflex decreases with age and tends to be more pronounced in young, healthy patients, which is clinically significant for pediatric as it is observed with greatest incidence in young healthy neonates and infants undergoing strabismus surgery. Objective to prevent and attenuate the oculocardiac reflex in children age group from (2yrs to 14 yrs) undergoing surgical correction for strabismus. Patients and Methods Three groups were allocated Group C received general anaesthesia combined with pre emptive atropine, Group L received general anaesthesia combined with Peribulbar block with Lidocaine 2 % and Group LB which received general anaesthesia combined with peribulbar block with Levobupivacaine 0.5%. Results In Our study we found that group L which received peribulbar lidocaine 2 % was the most successful group regarding blocking the occurrence of the OCR and with acceptable post operative pain control results. Conclusion In Our study the use of peribulbar block with lidocaine 2 % in combinations with General anaesthesia is very effective against the incidence of OCR in children undergoing strabismus surgery and superior to the Iv pre emptive Atropine with higher surgeon satisfaction while the use of peribulbar levobupivacaine 0.5% combined with general anaesthesia has a great role in post operative pain control with superior patient satisfaction, on the other hand the atropine is a very important emergency drug but our study found that it has a very minor role in both preventing the OCR and post operative pain control in addition to subjecting the patients to the tachycardia and other complications like dryness of the mouth and blushing so its not recommended by our study.

The Discovery of Retrolental Fibroplasia and the Role of Oxygen: A Historical Review, 1942–1956

2004 ◽  
Vol 23 (2) ◽  
pp. 31-38 ◽  
Author(s):  
Elizabeth Reedy
Keyword(s):  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Historical Review ◽  
Retrolental Fibroplasia ◽  
History Of ◽  
To Come ◽  
The 1960S ◽  
Prematurely Born Infants ◽  
The U.S

Nearly 50 years after it was thought to be conquered, retinopathy of prematurity (ROP) continues to cause vision disturbances and blindness among prematurely born infants. During the 1940s and early 1950s, researchers and caregivers first identified and struggled to eliminate this problem, which seemed to come from nowhere and was concentrated among the most advanced premature nurseries in the U.S. Research studies initially identified many potential causes, none of which could be proved conclusively. By the mid-1950s, oxygen was identified as the culprit, and its use was immediately restricted. The rate of blindness among premature infants decreased significantly. ROP was not cured, however. By the 1960s, it had reappeared. The history of ROP serves to remind us that, despite our best intentions, the care and treatment of premature newborns will always carry with it the possibility of iatrogenic disease. This caution is worth remembering as we work to expand the quality and quantity of clinical research.

scholarly journals Screening premature infants for retinopathy of prematurity in a tertiary hospital in Saudi Arabia

2020 ◽  
Vol 40 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Enas Mgharbil ◽  
Lina Hassan Raffa ◽  
Sara Alessa ◽  
Aliaa Alamri
Keyword(s):  
Saudi Arabia ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Tertiary Hospital

Tocopherol Efficacy and Safety for Preventing Retinopathy of Prematurity: A Randomized, Controlled, Double-Masked Trial

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 489-500 ◽  
Author(s):  
Dale L. Phelps ◽  
Arthur L. Rosenbaum ◽  
Sherwin J. lsenberg ◽  
Rosemary D. Leake ◽  
Frederick J. Dorey
Keyword(s):  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Plasma Levels ◽  
Late Onset ◽  
Retinal Hemorrhage ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Late Onset Sepsis ◽  
Prospective Monitoring

To test the efficacy and safety of vitamin E in preventing retinopathy of prematurity, 287 infants with birth weights of less than 1.5 kg or gestational ages of less than 33 weeks were enrolled within 24 hours of birth in a randomized, double-masked trial of IV, followed by oral, placebo v tocopherol (adjusted to plasma levels of 3 to 3.5 mg/dL). In the 196 infants completing ophthalmic follow-up, tocopherol did not prevent retinopathy of prematurity of any stage (28% placebo treated v 26% tocopherol treated) or moderately severe retinopathy of prematurity (8% placebo treated v 11% tocopherol treated). Cicatricial sequelae were not significantly different (1/97 placebo treated v 3/99 tocopherol treated), with one placebo-treated infant and one tocopherol-treated infant having retinal detachments. Among all 232 infants examined, those treated with tocopherol had more retinal hemorrhage than placebo-treated infants (8/121 placebo treated v 16/111 tocopherol treated), and retinal hemorrhage correlated positively (P < .01) with plasma levels of tocopherol after the first 2 weeks of age. Prospective monitoring of morbidity including late-onset sepsis, necrotizing enterocolitis, etc revealed no differences between groups except that grades 3 and 4 intraventricular hemorrhage occurred more frequently in infants weighing less than 1 kg at birth who had received tocopherol (14/42, 33%) v those who had received placebo (4/43, 9%) (P < .02). Our data do not support the use of tocopherol for prophylaxis against retinopathy of prematurity in premature infants and suggest that IV tocopherol treatment starting on day 1 may increase the incidence of hemorrhagic complications of prematurity, particularly in infants with birth weights of less than 1 kg.

Surgical Treatment in Retinopathy of Prematurity

2018 ◽  
pp. 48-51
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Vascular Disease ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Visual Function ◽  
Recent Literature ◽  
Special Focus ◽  
Timely Manner ◽  
Retinal Vascular Disease

Retinopathy of Prematurity (ROP) is a retinal vascular disease that affects premature infants and can progress to retinal detachment and blindness. With the increasing survival of premature infants and increased incidence of ROP, it is important to treat patients in a timely manner to preserve their visual function and reduce complications. The purpose of this review is to provide an overview of the recent literature on ROP with a special focus on recent advances in surgical therapy.

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