Anesthesia for elective eye surgery
- Alvaro A Macias, MD
Alvaro A Macias, MD
- Instructor in Anesthesia
- Massachusetts Eye and Ear Infirmary
- Harvard Medical School
- Joseph Bayes, MD
Joseph Bayes, MD
- Massachusetts Eye and Ear (Emeritus)
- Assistant Professor of Anesthesia
- Harvard Medical School
- Kathryn E McGoldrick, MD, FCAI(Hon)
Kathryn E McGoldrick, MD, FCAI(Hon)
- Professor and Chair, Emeritus
- Advisory Dean for Student Affairs, Emeritus College of Medicine, New York Medical College, Valhalla, New York
- Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review (CLER) Department of Institutional Accreditation
The goals of anesthetic care during elective eye surgery are pain-free surgery, facilitation of the surgical procedure, rapid recovery, and minimization of risks associated with surgery and anesthesia.
This topic reviews the techniques for providing analgesia, sedation, or anesthesia during cataract, glaucoma, and vitreoretinal surgery. Other aspects of surgical management of these conditions are discussed separately. (See "Cataract in adults", section on 'Treatment' and "Open-angle glaucoma: Treatment", section on 'Types of therapy' and "Angle-closure glaucoma", section on 'Treatment' and "Retinal detachment", section on 'Treatment'.)
ANESTHESIA FOR CATARACT SURGERY
Cataract surgery is one of the most common procedures requiring anesthetic care .
Preoperative consultation — The preoperative medical evaluation is reviewed in detail elsewhere, including preoperative testing, evaluation of comorbid conditions, and perioperative decisions regarding chronically administered medications. (See "Cataract in adults", section on 'Preoperative medical evaluation'.)
Consultation for anesthetic management emphasizes the following additional considerations :
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- ANESTHESIA FOR CATARACT SURGERY
- Preoperative consultation
- - Anesthetic considerations
- - Ophthalmic considerations
- Monitoring and sedation
- - Needle insertion for regional anesthesia
- - Surgical procedure
- Anesthetic techniques
- - Topical anesthesia
- - Regional anesthesia
- Commonly used agents
- Peribulbar block (extraconal block)
- Retrobulbar block (intraconal block)
- Sub-Tenon block
- - General anesthesia
- ANESTHESIA FOR INTRAOCULAR GLAUCOMA SURGERY
- ANESTHESIA FOR VITREORETINAL SURGERY
- ANESTHETIC COMPLICATIONS
- Ophthalmologic complications
- - Globe or optic nerve perforation
- - Hemorrhage
- - Intramuscular injection
- Oculocardiac reflex manifestations
- Systemic complications
- SUMMARY AND RECOMMENDATIONS