ABSTRACT
Objetivo: Analizar la eficacia y utilidad de la anestesia tópica de contacto en cirugía de estrabismo en pacientes adultos. Material y método: Estudio prospectivo de 20 pacientes intervenidos de estrabismo utilizando anestesia tópica de contacto más sedación con remifentanilo. Mediante la escala numérica del dolor se registró la intensidad de este en el momento de la aplicación de la anestesia, durante la intervención quirúrgica, a los 30 min y durante el primer día posoperatorio. Se valoró la aparición de reflejo oculocardiaco durante la intervención, la incidencia de náuseas y vómitos posoperatorios, la presencia de úlceras corneales, la satisfacción de los pacientes de forma numérica del 0 al 10, y el grado de desviación ocular residual. Resultados: La intervención quirúrgica se realizó de forma satisfactoria en todos los pacientes. La intensidad del dolor fue de 1,40 ± 1,73 en el momento de la aplicación de la anestesia; 4,20 ± 2,57 durante el desarrollo de la intervención; 2,50 ± 2,54 a los 30 min, y 3,55 ± 2,89 durante el primer día posoperatorio. Se observó aparición de reflejo oculocardiaco en 7 pacientes (35%), náuseas y vómitos posoperatorios en 4 (20%), y úlcera corneal en 4 (20%). La satisfacción de los pacientes alcanzó un valor promedio de 9,53 ± 2,51. El 70% de los pacientes presentaban una desviación ocular residual menor a 10 dioptrías prismáticas. Conclusiones: La anestesia tópica de contacto es una alternativa segura y eficaz para la cirugía del estrabismo en pacientes adultos. Permite un adecuado control del dolor, ofrece una baja incidencia de reflejo oculocardiaco y náuseas y vómitos posoperatorios, y proporciona un ajuste óptimo de la alineación ocular (AU)
Objective: To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. Material and methods: A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed. Results: The operation was performed successfully in all patients. Average pain intensity was 1.40 ± 1.73 during anesthesia implementation, 4.20 ± 2.57 during the surgical procedure, 2.50 ± 2.54 30 min after surgery, and 3.55 ± 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 ± 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters. Conclusions: Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment (AU)
Subject(s)
Humans , Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Strabismus/surgery , Administration, Topical , Pain, Postoperative/drug therapy , Ophthalmologic Surgical Procedures/methods , Ambulatory Surgical Procedures/methods , Prospective StudiesABSTRACT
OBJECTIVE: To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. MATERIAL AND METHODS: A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed. RESULTS: The operation was performed successfully in all patients. Average pain intensity was 1.40 ± 1.73 during anesthesia implementation, 4.20 ± 2.57 during the surgical procedure, 2.50 ± 2.54 30 min after surgery, and 3.55 ± 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 ± 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters. CONCLUSIONS: Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment.
