Anesthetic support for laser vision correction in children

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

BACKGROUND: Currently, more and more laser surgeries are performed in pediatric ophthalmology. Expansion of indications for laser vision correction in children entails the increase in the number of patients and poses new specific tasks for pediatric anesthesiology. Solution of these problems is currently at the stage of active clinical search.

AIM: To propose a safe, reproducible and controllable method of anesthesiological support at pediatric ophthalmic surgeries which would ensure complete immobility of the eyeball during the intervention and patient’s rapid awakening after the surgery.

METHODS: A retrospective trial has been conducted. From October 2016 to May 2022, in the hospital of Joint Stock Company "Medicine" (clinic of Academician Roitberg) specialists from Yasny Vzor Children's Eye Clinics of Professor Igor Aznauryan operated on 429 children with ophthalmosurgical pathology. Laser vision correction was performed in children with refractive errors (astigmatism, hyperopia, congenital stable high myopia) complicated by anisometropia and/or amblyopia. The composite endpoint was surgeon's satisfaction with eye position during the main intervention and at the time of patient's awakening at the end of surgical stage. The surgeon's satisfaction was assessed with a 10-point scale, where 1 means no centration achieved and 10 means complete immobility during the correction. Awakening was the time from the end of surgical procedure until the removal of laryngeal mask after restoration of spontaneous breathing and signs of consciousness.

RESULTS: All 429 patients included in the trial completed it. Awakening came quickly and lasted, on average, 13.3 min (95% confidence interval, 12.1–14.6 min). At the early postoperative period, pain syndrome was in significant and amounted to 1–3 points by the Face, Legs, Activity, Cry, Consolability Scale and to 1–2 points by the Visual Analogue Scale. Additional anesthesia (Ibuprofen) was required in less than 10% of patients. Nausea, vomiting, and muscle pain were not observed in the postoperative period.

CONCLUSION: The proposed technique is adequate for ensuring the eyeball immobility and for acceptable wake-up time up to 9–10 points by the Aldreth scale.

Full Text

Restricted Access

About the authors

Grigorij E. Roitberg

Joint Stock Company "Medicine"

Email: contact@medicina.ru
ORCID iD: 0000-0003-0514-9114
SPIN-code: 1032-9122

MD, Dr. Sci. (Medicine), Professor

Россия, 10 2nd Tverskoy-Yamskoy lane, 125047 Moscow

Igor E. Aznauryan

"Yasny Vzor" Limited Liability Company

Email: aznauryan@prozrenie.ru
ORCID iD: 0000-0002-4805-0299

MD, Dr. Sci. (Medicine), Professor

Россия, Moscow

Oleg V. Strunin

Joint Stock Company "Medicine"; Peoples' Friendship University of Russia

Email: struninov@gmail.com
ORCID iD: 0000-0003-2537-954X
SPIN-code: 4734-0837

MD, Dr. Sci. (Medicine), Professor

Россия, 10 2nd Tverskoy-Yamskoy lane, 125047 Moscow; Moscow

Igor V. Smirnov

Joint Stock Company "Medicine"

Author for correspondence.
Email: smirnov@medicina.ru
ORCID iD: 0000-0002-5348-3400
SPIN-code: 2224-3530

Ведущий анестезиолог-реаниматолог

Россия, 10 2nd Tverskoy-Yamskoy lane, 125047 Moscow

Victoria O. Balasanyan

"Yasny Vzor" Limited Liability Company

Email: balasanyan@prozrenie.ru
ORCID iD: 0000-0002-8340-4531

MD, Cand. Sci. (Medicine)

Россия, Moscow

Satenik G. Agagulyan

"Yasny Vzor" Limited Liability Company

Email: agagulyan@prozrenie.ru
ORCID iD: 0000-0003-1289-2117

MD

Россия, Moscow

Natalia V. Kondratova

Joint Stock Company "Medicine"

Email: kondratova@medicina.ru
ORCID iD: 0000-0003-2421-0558
SPIN-code: 6090-2734

MD, Dr. Sci. (Medicine), Professor

Россия, 10 2nd Tverskoy-Yamskoy lane, 125047 Moscow

Vladimir V. Lazarev

The Russian National Research Medical University named after N.I. Pirogov

Email: lazarev_vv@inbox.ru
ORCID iD: 0000-0001-8417-3555
SPIN-code: 4414-0677

MD, Dr. Sci. (Medicine), Professor

Россия, Moscow

References

  1. Yin ZQ, Wang H, Yu T, et al. Facilitation of amblyopia management by laser in situ keratomileusis in high anisometropic hyperopic and myopic children. J AAPOS. 2007;11(6):571–576. doi: 10.1016/j.jaapos.2007.04.014
  2. Korobova LS. Anaesthesiological support of surgical interventions in ophthalmosurgery in children [dissertation abstract]. Moscow, 2019. 24 р. (In Russ.)
  3. Homer R, Walker E, Bell G, et al. Intensive care and anaesthesia in children. A practical guide. World Federation of Societies of Anaesthesiologists. 2017. Р. 241–244. (In Russ).
  4. Patent RUS № 2444342 / 10.03.12. Byul. № 7. Lautkina LYa, Litasova YuA, Sadrutdinov RSh. Method of performing refractive surgery in children. (In Russ.) EDN: ZGHIGT
  5. William FA, Peter TH, Anna LE, et al. Photorefractive keratectomy in children. Cataract Refract Surg. 2002;28(6):932–941. doi: 10.1016/s0886-3350(02)01304-4
  6. Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesthesia. 1995;7(1):89–91. doi: 10.1016/0952-8180(94)00001-k

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2024 Roitberg G.E., Aznauryan I.E., Strunin O.V., Smirnov I.V., Balasanyan V.O., Agagulyan S.G., Kondratova N.V., Lazarev V.V.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies