Anesthetic support for laser vision correction in children
- Authors: Roitberg G.E.1, Aznauryan I.E.2, Strunin O.V.1,3, Smirnov I.V.1, Balasanyan V.O.2, Agagulyan S.G.2, Kondratova N.V.1, Lazarev V.V.4
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Affiliations:
- Joint Stock Company "Medicine"
- "Yasny Vzor" Limited Liability Company
- Peoples' Friendship University of Russia
- The Russian National Research Medical University named after N.I. Pirogov
- Issue: Vol 28, No 2 (2024)
- Pages: 151-157
- Section: ORIGINAL STUDY
- Submitted: 13.07.2023
- Accepted: 20.10.2023
- Published: 30.05.2024
- URL: https://jps-nmp.ru/jour/article/view/703
- DOI: https://doi.org/10.17816/ps703
- ID: 703
Cite item
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.
Keywords
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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 MoscowIgor E. Aznauryan
"Yasny Vzor" Limited Liability Company
Email: aznauryan@prozrenie.ru
ORCID iD: 0000-0002-4805-0299
MD, Dr. Sci. (Medicine), Professor
Россия, MoscowOleg 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; MoscowIgor 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 MoscowVictoria O. Balasanyan
"Yasny Vzor" Limited Liability Company
Email: balasanyan@prozrenie.ru
ORCID iD: 0000-0002-8340-4531
MD, Cand. Sci. (Medicine)
Россия, MoscowSatenik G. Agagulyan
"Yasny Vzor" Limited Liability Company
Email: agagulyan@prozrenie.ru
ORCID iD: 0000-0003-1289-2117
MD
Россия, MoscowNatalia 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 MoscowVladimir 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, MoscowReferences
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