Akademik Veri Yönetim Sistemi
3. Uluslararası Anesteziyoloji ve Reanimasyon Sempozyumu, Bursa, Türkiye, 1 - 02 Aralık 2023, cilt.1, ss.137-138
Giriş - Amaç: This century has witnessed major advancements in ophthalmic surgery with the adoption of minimally-invasive techniques, technologic innovations, and an expanding population seeking eye care and many procedures are now performed on more comorbid patients, (1)Ophthalmic regional anesthesia(ORA) with monitoried anesthesia care(MAC) is a viable alternative for many ocular insults, particularly for the elderly and patients with major organ dysfunction. Nowadays anesthesiologists are shifting away from retrobulbar to peribulbar block. Sub-Tenon block (STB) is used primaliry for cataract but it is also useful and effective in other eye surgeries(2). We aimed to present our ORA management in three patients.
Phenomenon: All patients sedated with dexmetodimidin, midazolam and fentanyl with proper dose.Case1:A 73-year-old female patient with Alzheimer desease, DM, was treated with peribulbar block (5 cc 2% lidocaine) for strabismus operation. Case2: A 50-year-old female patient who had undergone brain aneurysm surgery had a very low TSH level (0.02 uIU/ml). Peribulbar block was applied to the patient with 4cc of 2% lidocaine for strabismus surgery. Partial akinesia occured. Case 3: A 58-year-old patient with high TSH (35,06 uIU/ml), COPD,DM and arrhythmia was taken into emergency surgery due to detachment. STB applied with 7 cc lidocaine + marcain. Complete akinesia was achieved. Minimal kemosis was seen. No major complications developed in three patients and they were discharged without any problems.
Discussion - Conclusion: Many ophthalmic interventions are now managed under ORA. Anesthesiologists must adapt their management plans looking to alternative regional techniques and short-acting medications that promote rapid awakening and ambulation. Anaesthetic techniques have contributed to improved efficiency, cost savings and safety while maintaining patients’ satisfaction (3). ORA reduces the risk of anesthesia in risky cases that cannot receive general anesthesia or cannot wait, but also has many advantages. ORA- MAC can be safely used as an alternative to general anesthesia in cases with comorbidities(4).