Особенности анестезиологического обеспечения при проведении операций при повышенном внутриглазном давлении

Abstract

Purpose. To develop an algorithm for selection of anesthetic drugs and their dosages for adequate and safe anesthesia during surgical interventions that are performed on patients to reduce elevated intraocular pressure and to minimize the complications that may arise during anesthesia. Methods. The study included 86 cases that underwent surgery to reduce elevated intraocular pressure; 34 surgeries were performed under sub-Tenon anesthesia (39.6 %), 2 under parabulbar (2.3 %) and 50 (58.1 %) under peribulbar regional anesthesia. All the patients underwent dynamic monitoring of homeostasis. Anesthesia support consisted of preoperative preparation, regional anesthesia and drugs administered as a bolus in the operating room. Results and discussion. A list of drugs used during operations performed with increased intraocular pressure has been compiled. The most rational and safe dosages of drugs have been determined. After the introduction of this algorithm, not a single complication was obtained as a result of anesthesia. Conclusions. Implementation of the algorithm for intraoperative anesthesia in patients with elevated intraocular pressure made it possible to achieve: 1) adequate nociceptive and psychoemotional protection; 2) comfort conditions both for patients and for medical personnel; 3) minimizing anesthetic risks and complications. Key words: anesthesiology; ophthalmology; glaucoma; increased intraocular pressure; regional anesthesia.