目的:选择眼科手术的麻醉剂对外科医生具有至关重要的意义。麻醉师,和病人。这篇教育综述探讨了眼科中常见的麻醉类别。此外,我们讨论白内障特有的考虑因素,青光眼,斜视,轨道,眼塑,和眼外伤手术.
方法:使用主题标题“麻醉”的组合进行了全面的Embase搜索,“眼科手术”,“眼科”和“白内障摘除”,\"青光眼\",\"斜视\",“玻璃体视网膜手术”,“视网膜手术”,“眼睛受伤”,和“眼睑重建”。
结果:局部麻醉药是最常用的眼部麻醉形式,用于办公室和外科手术,并携带最小的副作用。值得注意的是,局部麻醉药提供镇痛,但不要提供运动障碍或健忘症。区域性区块,例如Sub-Tenon\'s,球周,和球后块,当除了镇痛之外还需要运动障碍时使用。最近,sub-Tenon\'s块最近获得了普及,由于其改进的安全性相比其他区域块。全身麻醉被认为是长期的,复杂的手术,多种合并症患者的手术,年轻儿科患者的手术,或对局部或区域麻醉药不耐受的患者进行手术。
结论:近年来眼睛麻醉发展迅速,支持安全,眼科手术的疗效和舒适度。由于眼科手术有许多可行的麻醉剂选择,对患者需求的强烈理解,手术团队的技能,在制定手术麻醉计划时,应考虑特定于手术的因素。
OBJECTIVE: Selecting an anesthetic agent for ophthalmic surgery has crucial implications for the surgeon, anesthesiologist, and patient. This educational
review explores the common classes of anesthesia used in ophthalmology. Additionally, we discuss the considerations unique to cataract, glaucoma, strabismus, orbital, oculoplastic, and ocular trauma surgeries.
METHODS: A comprehensive Embase search was performed using combinations of the subject headings \"anesthesia\", \"eye surgery\", \"ophthalmology\" and \"cataract extraction\", \"glaucoma\", \"strabismus\", \"vitreoretinal surgery\", \"retina surgery\", \"eye injury\", and \"eyelid reconstruction\".
RESULTS: Topical anesthetics are the most commonly used form of ocular anesthesia, used in both an office and surgical setting, and carry a minimal side effect profile. Notably, topical anesthetics offer analgesia, but do not provide akinesia or amnesia. Regional blocks, such as are sub-Tenon\'s, peribulbar, and retrobulbar blocks, are used when akinesia is required in addition to analgesia. Recently, sub-Tenon\'s blocks have recently gained popularity due to their improved safety profile compared to other regional blocks. General anesthesia is considered for long, complex surgery, surgery in patients with multiple comorbidities, surgery in young pediatric patients, or surgery in patients intolerant to local or regional anesthetic.
CONCLUSIONS: Anesthetizing the eye has rapidly evolved in recent years, supporting the safety, efficacy and comfort of ocular surgery. Since there are many viable options of anesthetics available for ophthalmic surgery, a robust understanding of the patients needs, the skill of the surgical team, and surgery-specific factors ought to be considered when creating an anesthetic plan for surgery.