Анестезиологическое пособие в дакриохирургии

Abstract

Operations on the lacrimal pathways at present no longer represent complex orbital-nasal interventions, as it was 15–20 years ago, therefore, there may be an alternative to general anesthesia with reliable airway patency and its protection from aspiration. Aim of the study was to evaluate the advantages and disadvantages of various types of anesthesia and to determine the optimal one when performing various dacryosurgical interventions. Methods. The study group included patients aged 17 to 79 years with various forms of dacryostenosis, who, according to the results of a preoperative examination, were assigned to endonasal endoscopic dacryocystorinostomy and lacrimal recanalization with intubation. The patients were divided into 2 groups, the first of which underwent endonasal coblation dacryocystorhinostomy, the second – lacrimal recanalization with intubation. Each group was divided into 2 subgroups depending on the type of anesthesia chosen (general or local). Results. When performing endonasal endoscopic coblation dacryocystorhinostomy, 83.9 % of patients noted insufficiency of local anesthesia, and when performing recanalizing operations on the lacrimal tract, insufficiency of anesthesia was noted by only 18.5 % of patients. Conclusions. Endonasal dacryocystorhinostomy, despite the innovations that have turned it into a minimally invasive procedure, remains a painful operation, for which general anesthesia is preferable. Flexible laryngeal mask creates optimal conditions during awakening and provides protection of the respiratory tract after performing all types of dacryosurgical interventions. Key words: dacryology, anesthesiology, anesthesia, dacryosurgery, dacryocystorhinostomy, lacrimal recanalization, lacrimal pathways.