Ophthalmic surgery is one of the most frequent surgical procedures requiring anesthesia in developed countries. Perioperative morbidity and mortality rates associated with eye surgery are low. Nevertheless, because patients with cataracts tend to be older and to have serious comorbidities, systematic preoperative evaluation should be performed to consider a patient eligible for surgery. Anesthetic management may contribute to the success or failure of ophthalmic surgery.
Ocular surgery may be performed under topical, local or general anesthesia. Local anaesthesia is more preferred because it is economical, easy to perform and the risk involved is less. Local anaesthesia has a rapid onset of action and provides a dilated pupil with low intraocular pressure.
This issue of Site News explores the Introduction of Anesthesia, Principles and Techniques, Anesthesia and Ocular Surgeries. It also brings to you Complications, Guidelines, Awareness, Monitoring, History and Society.
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Local anaesthesia is currently performed for many ophthalmic procedures as it is associated with reduced morbidity and mortality when compared with general anaesthesia. Additional benefits include early patient mobilisation, improved patient satisfaction and reduced hospital stay. A variety of different methods of administration are described which may be broadly divided into 'injections' or 'topical applications'. 'Injection' techniques all involve needle perforation of the peri-orbital skin or conjunctiva and injection of local anaesthetic into the peri-orbital or orbital tissues. Orbital injections are occasionally associated with serious sight or even life-threatening complications. In contrast 'topical' anaesthesia, where local anaesthetic eye drops are applied to the surface of the eye, is non-invasive and has virtually no complications. It is becoming increasingly popular for phacoemulsification cataract surgery although many other procedures may also be performed topically.
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