[New anaesthetic technique in diode laser treatment of retinopathy of prematurity]. / Nueva técnica anestésica en el tratamiento con láser diodo de la retinopatía del prematuro.

INTRODUCTION: Anaesthesia in premature infants can have many complications. Although the application of diode laser is less painful than cryotherapy, there has to be adequate immobilization of the patient to provide a correct focus of the spot. At Hospital Infantil de Zaragoza, the same standard anaesthetic technique has been applied since 1999, obtaining sedation with inhaled anaesthetic agents combined with topical anaesthesia. We analyse the results obtained on the application of this technique. MATERIAL AND METHOD: The study included 72 consecutive premature infants treated with diode laser for retinopathy of prematurity (ROP), using an anaesthetic technique combining inhalatory sedation and topical anaesthesia. The personal data of each patient was collected (gestational age, birth weight, postconceptional age at the time of initial treatment, associated systemic disorders) together with information related to the surgical intervention (duration, intraoperative and postoperative complications). RESULTS: Intraoperative complications occurred in 12 cases (16.66%). These were self-limited in 9 cases and only 3 cases required orotracheal intubation (4.16%). Postoperative complications occurred in 4 cases (5.55%) during the 48 h following treatment. No statistically significant relationship was found between the presence of intraoperative complications and the mean gestational age and birth weight, and the presence of apnoea, intraventricular haemorrhage or a permeable ductus. A statistically significant relationship was found between the presence of postoperative complications and significant intraventricular haemorrhage. CONCLUSIONS: This anaesthetic technique combining inhalatory gases and topical anaesthesia is safe, with few complications and comfortable for the surgeon.

Nueva técnica anestésica en el tratamiento con láser diodo de la retinopatía del prematuro / New anaesthetic technique in diode laser treatment of retinopathy of prematurity

Introducción: La anestesia en prematuros es susceptible de tener múltiples complicaciones. Aunque la aplicación del láser diodo es menos dolorosa que la crioterapia, se debe conseguir una correcta inmovilización del paciente para un enfoque y una aplicación adecuados del mismo. Desde 1999 está protocolizada en el Hospital Infantil de Zaragoza una técnica anestésica que utiliza sedación con agentes inhalatorios asociada a anestesia tópica. Analizamos los resultados obtenidos en la utilización de dicha técnica. Material y método: Se incluyen 72 prematuros consecutivos tratados con láser por retinopatía del prematuro (ROP) utilizando la técnica anestésica de sedación inhalatoria y anestesia tópica. Se han recogido datos de los pacientes (edad gestacional, peso al nacer, edad posconcepcional en el momento del tratamiento inicial, patología sistémica asociada) y del acto quirúrgico (tiempo de duración y complicaciones intraoperatorias y postoperatorias). Resultados: Se produjeron complicaciones intraoperatorias en 12 casos (16,66 %). En 9 casos fueron autolimitadas y sólo 3 precisaron intubación orotraqueal (4,16 %). En 4 casos (5,55 %) se produjeron complicaciones postoperatorias en las 48 h posteriores al tratamiento. No se encontró relación estadísticamente significativa entre la presencia de complicaciones intraoperatorias y la media de edad gestacional y peso al nacer o la presencia de apneas, hemorragia intraventricular o ductus permeable. Se encontró relación estadísticamente significativa entre la presencia de complicaciones postoperatorias y la presencia de hemorragia intraventricular significativa. Conclusiones: La técnica anestésica con gases inhalatorios asociada a anestesia tópica es segura, con escasa proporción de complicaciones y cómoda para el cirujano (AU)

Introduction: Anaesthesia in premature infants can have many complications. Although the application of diode laser is less painful than cryotherapy, there has to be adequate immobilization of the patient to provide a correct focus of the spot. At Hospital Infantil de Zaragoza, the same standard anaesthestic technique has been applied since 1999, obtaining sedation with inhaled anaesthetic agents combined with topical anaesthesia. We analyse the results obtained on the application of this technique. Material and method: The study included 72 consecutive premature infants treated with diode laser for retinopathy of prematurity (ROP), using an anaesthestic technique combining inhalatory sedation and topical anaesthesia. The personal data of each patient was collected (gestational age, birth weight, postconceptional age at the time of initial treatment, associated systemic disorders) together with information related to the surgical intervention (duration, intraoperative and postoperative complications). Results: Intraoperative complications occurred in 12 cases (16.66 %). These were self-limited in 9 cases and only 3 cases required orotracheal intubation (4.16 %). Postoperative complications occurred in 4 cases (5.55 %) during the 48 h following treatment. No statistically significant relationship was found between the presence of intraoperative complications and the mean gestational age and birth weight, and the presence of apnoea, intraventricular haemorrhage or a permeable ductus. A statistically significant relationship was found between the presence of postoperative complications and significant intraventricular haemorrhage. Conclusions: This anaesthestic technique combining inhalatory gases and topical anaesthesia is safe, with few complications and comfortable for the surgeon (AU)