Our Summary

This research paper talks about the different types of anesthetics used during eye surgeries. The type of anesthetic chosen is important for the surgeon, the anesthesiologist, and the patient. The most commonly used anesthetics for eye surgeries are topical anesthetics. These are used in both office and surgical settings and have very few side effects. However, they only provide pain relief and do not cause loss of movement or memory.

For surgeries that require the eye to be completely still, regional blocks are used. These include sub-Tenon’s, peribulbar, and retrobulbar blocks. Lately, more and more people are preferring sub-Tenon’s blocks because they are safer compared to other regional blocks.

General anesthesia, which makes the patient completely unconscious, is used for long and complex surgeries, surgeries in patients with multiple health problems, surgeries in young children, or surgeries in patients who cannot tolerate local or regional anesthetic.

The paper concludes that the method of anesthetizing the eye has greatly improved in recent years, making eye surgeries safer, more effective, and more comfortable. Because there are many types of anesthetics available, the patient’s needs, the surgical team’s skills, and specific factors related to the surgery should all be considered when deciding on an anesthetic plan.

FAQs

  1. What are the most commonly used anesthetics for eye surgeries?
  2. Why are sub-Tenon’s blocks becoming more popular for ocular surgeries?
  3. In what circumstances is general anesthesia used for eye surgeries?

Doctor’s Tip

A helpful tip a doctor might give a patient about ocular surgery is to follow all pre-operative instructions provided by the surgical team, such as avoiding eating or drinking before surgery, taking prescribed medications as directed, and arranging for transportation to and from the surgical facility. It is also important to inform the surgical team of any allergies, medical conditions, or medications being taken. Following these instructions can help ensure a successful surgery and smooth recovery.

Suitable For

Patients who are typically recommended for ocular surgery include those with conditions such as cataracts, glaucoma, retinal detachment, macular degeneration, diabetic retinopathy, and strabismus. These conditions can cause vision problems that may require surgery to improve or correct. Additionally, patients with eye injuries or tumors may also require ocular surgery.

The decision to undergo ocular surgery is typically made in consultation with an ophthalmologist who will assess the patient’s eye health and determine the best course of treatment. Factors such as the severity of the condition, the patient’s overall health, and their ability to tolerate surgery will all be taken into consideration when recommending ocular surgery.

Overall, patients who are experiencing significant vision problems or eye conditions that cannot be effectively treated with medication or other non-invasive methods may be recommended for ocular surgery. It is important for patients to consult with their healthcare provider to determine the best treatment option for their individual needs.

Timeline

Before ocular surgery:

  1. Patient consults with an ophthalmologist to discuss the need for surgery and the potential risks and benefits.
  2. Pre-operative testing is done to assess the patient’s overall health and eye condition.
  3. Anesthesia options are discussed with the patient and a plan is made.
  4. Patient is instructed on pre-operative care, such as fasting before surgery.

During ocular surgery:

  1. Patient is given the chosen anesthesia, whether it be topical, regional block, or general anesthesia.
  2. Surgery is performed by the ophthalmologist, with the patient either awake or asleep depending on the type of anesthesia used.
  3. Patient may experience sensations of pressure or movement during the surgery but should not feel pain.

After ocular surgery:

  1. Patient is monitored in a recovery area until they are stable and can be discharged.
  2. Instructions are given for post-operative care, such as using eye drops, wearing a protective shield, and avoiding certain activities.
  3. Follow-up appointments are scheduled to monitor the healing process and assess the success of the surgery.
  4. Patient may experience some discomfort, redness, or blurry vision in the days following surgery, but this should improve over time.

What to Ask Your Doctor

Some questions a patient should ask their doctor about ocular surgery include:

  1. What type of anesthesia will be used for my eye surgery?
  2. What are the potential risks and side effects of the anesthesia?
  3. Will I be completely unconscious during the surgery or will I be awake?
  4. Are there any specific precautions I need to take before the surgery in relation to the anesthesia?
  5. How long will the effects of the anesthesia last after the surgery?
  6. Will I need someone to drive me home after the surgery due to the effects of the anesthesia?
  7. Are there any alternative anesthesia options available for my surgery?
  8. How experienced is the anesthesiologist who will be administering the anesthesia?
  9. How will the anesthesia be monitored during the surgery to ensure my safety?
  10. What should I expect in terms of pain management after the surgery?

Reference

Authors: Pucchio A, Pur DR, Dhawan A, Sodhi SK, Pereira A, Choudhry N. Journal: Int Ophthalmol. 2023 May;43(5):1761-1769. doi: 10.1007/s10792-022-02564-3. Epub 2022 Nov 27. PMID: 36436168