Крылонебная блокада в алгоритме послеоперационного обезболивания кросслинкинга роговицы

Abstract

Postoperative period in cross-linking is often known to be complicated by presence of pain syndrome of varying intensity due to corneal deepithelization during surgery which negatively affects postoperative rehabilitation. Pterygopalatine blockade by infrazygomatic access refers to minimally invasive interventions and has a sufficiently high analgesic profile, which serves as a justification for its use for the purpose of anesthesia. A therapeutic blockade with levobupivacaine at the end of surgery can create a long-term analgesic effect by a single injection. Purpose. To evaluate the efficacy of pterygopalatine blockade for corneal cross-linking postoperative anesthesia. Methods. A retrospective study: group 1–15 patients who underwent pterygopalatine blockade at the end of the operation, group 2 – 13 patients who took NSAIDs for postoperative anesthesia. The level of pain, the number of prescribed analgesics and the level of the patient's comfort were taken into account. Results. After the surgery, 69.2 % of patients in the second group complained of pain 6 hours later, average pain score on the Verbal Rating Scale (VRS) was 1.1±0.92, in group 1 there was no pain syndrome which led to a decrease in postoperative administration of analgesics in group 1. The level of comfort of patients in the early postoperative period was higher in group 1 and was 6.6 %. Conclusion. The use of pterygopalatine blockade at the end of corneal cross-linking operation allows to create a long-term analgesic effect, reduce lacrimation, thereby improving the patient's comfort level on the 1st day after surgery. Key words: pterygopalatine blockade; pain; levobupivacaine.