ABSTRACT
Introducción y objetivo: Las lesiones oculares durante cirugía son raras. Las causas comunes incluyen trauma directo, lesión química y exposición corneal. Las molestias oculares se pueden presentar después de la cirugía en ausencia de daño estructural del ojo. En nuestro hospital todos los pacientes sometidos a anestesia general reciben protección con oclusión ocular asociado en la mayoría de los casos con la aplicación de gel oftálmico. En este estudio buscamos analizar la incidencia de molestias oculares con la aplicación de gel oftálmico de carbómero 0,2%. Métodos: Se llevó a cabo un estudio tipo cohorte. Se incluyeron los pacientes sometidos a cirugía bajo anestesia general con duración menor a cuatro horas entre febrero y noviembre de 2017. Se excluyeron a los pacientes con patologías oculares previas, los llevados a cirugía oftálmica, facial o de cabeza, y aquellos en los que la oclusión ocular no fue posible. Para el análisis, los pacientes se dividieron en dos grupos: oclusión ocular simple (Grupo 1) y oclusión ocular más gel oftálmico de carbómero al 0,2% (Grupo 2). Nuestro desenlace primario fue la incidencia de molestias oculares y el desenlace secundario fue determinar los factores de riesgo. Resultados: Se analizaron 400 pacientes, de los cuales la mitad (50%) recibieron el gel oftálmico de carbómero 0,2%. No se encontraron diferencias en las características demográficas entre grupos. Durante las primeras 24 horas postoperatorias, el 7,25% de los pacientes presentaron síntomas visuales, y a los siete días postoperatorios ningún paciente refirió síntomas. Los síntomas más frecuentes fueron visión borrosa, prurito, epífora y ojo rojo. En el análisis multivariado el principal factor de riesgo asociado con la aparición de molestias oculares fue la aplicación de gel oftálmico de carbómero 0,2% (RR 13,5; IC 95% 3,2756,2). Otros factores asociados a molestias oculares fueron cirugía de urgencia y la edad.(AU)
Background and objective: Eye lesions during surgery are rare. Its common causes include direct trauma, chemical damage, and corneal exposure. Eye discomfort may present after surgery in the absence of structural damage. In our hospital, every patient under general anesthesia receives eye protection with eye occlusion associated in most cases with ophthalmic ointment application. We aim to analyze the incidence of eye discomfort with 0.2% carbomer application. Methods: A cohort study was conducted. Patients who underwent surgery under general anesthesia lasting less than 4hours between February and November 2017 were enrolled. We excluded patients with previous ophthalmologic pathology, those undergoing eye, otolaryngology, face or head surgery, and patients in which eye occlusion was not possible. For analysis, patients were divided into two groups: simple eyelid occlusion (Group 1) and eyelid occlusion plus ophthalmic ointment (Group 2). Primary outcome was the incidence of eye discomfort and secondary outcomes were to stablish associated risk factors. Results: 400 patients were analyzed, 50% were exposed to 0.2% carbomer. There was no difference in patients demographics. During the first 24hours post-surgery 7.25% of patients showed visual symptoms, and at one-week postoperative no patient referred symptoms. Most frequent symptoms were blurry vision, pruritus, epiphora and red-eye. On multivariate analysis, the main risk factor associated with eye discomfort was 0.2% carbomer application (RR 13.5 CI 3.27 56.2). Emergent surgery and age were also found to be risk factors. Conclusion: 0.2% carbomer does not prevent ophthalmologic symptoms after surgery and it may even increase them in short procedures.(AU)
Subject(s)
Humans , Male , Female , Ointments , Patients , Anesthesia, General , Eye Injuries , Cohort Studies , AnesthesiologyABSTRACT
BACKGROUND AND OBJECTIVE: Eye lesions during surgery are rare. Its common causes include direct trauma, chemical damage, and corneal exposure. Eye discomfort may present after surgery in the absence of structural damage. In our hospital, every patient under general anesthesia receives eye protection with eye occlusion associated in most cases with ophthalmic ointment application. We aim to analyze the incidence of eye discomfort with 0.2% carbomer application. METHODS: A cohort study was conducted. Patients who underwent surgery under general anesthesia lasting less than 4h between February and November 2017 were enrolled. We excluded patients with previous ophthalmologic pathology, those undergoing eye, otolaryngology, face or head surgery, and patients in which eye occlusion was not possible. For analysis, patients were divided into two groups: simple eyelid occlusion (Group 1) and eyelid occlusion plus ophthalmic ointment (Group 2). Primary outcome was the incidence of eye discomfort and secondary outcomes were to stablish associated risk factors. RESULTS: 400 patients were analyzed, 50% were exposed to 0.2% carbomer. There was no difference in patients' demographics. During the first 24h post-surgery 7.25% of patients showed visual symptoms, and at one-week postoperative no patient referred symptoms. Most frequent symptoms were blurry vision, pruritus, epiphora and red-eye. On multivariate analysis, the main risk factor associated with eye discomfort was 0.2% carbomer application (RR 13.5 CI 3.27-56.2). Emergent surgery and age were also found to be risk factors. CONCLUSION: 0.2% carbomer does not prevent ophthalmologic symptoms after surgery and it may even increase them in short procedures.
Subject(s)
Anesthesia, General , Humans , Cohort Studies , Anesthesia, General/adverse effects , Postoperative PeriodSubject(s)
Analgesia , Conscious Sedation , Adult , Algorithms , Critical Illness , Delirium , Evidence-Based Medicine , Humans , Intubation, Intratracheal , Liver Failure , Nervous System Diseases/surgery , Renal Insufficiency , Respiration, Artificial , Risk Factors , Substance Withdrawal SyndromeABSTRACT
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Subject(s)
Humans , Critical Illness/therapy , Analgesia/methods , Hypnotics and Sedatives/administration & dosage , Evidence-Based Medicine , Risk Factors , Pain/drug therapy , Anxiety/drug therapy , Delirium/drug therapyABSTRACT
La canalización de las venas centrales es un procedimiento realizado frecuentemente, sin embargo es un procedimiento que tiene riesgos y complicaciones. Este artículo aparte de ser una revisión bibliográfica actual, reporta 63 punciones, guiadas por ultrasonografía, realizadas en 21 pacientes con grados variables de coagulopatía a los que se les realizó un transplante hepático. La tasa de éxito de la canulación venosa fue del 100 por ciento. Se presentó una punción arterial en carótida interna la cual fue manejada con medidas locales. No se presentaron otras complicaciones mayores ni menores
