The Influence of the Type of Anaesthesia on the Frequency of Postoperative Haemorrhage Requiring Revision After Removal of the Silicone Oil Tamponade

Abstract

In this retrospective data analysis, it was examined whether the mode of anesthesia influenced postoperative haemorrhage in patients with first time complete silicone oil removal in 2002, 2005, 2010, 2014 - 2016 in our clinic and if there was a change in frequency over time. Haemorrhage was defined as a postoperative haemorrhage within 2 weeks after the operation and which led to revision vitrectomy. In all, there were 939 operations and 9 cases of postoperative surgery requiring revision in the analysed years. Even though the number of patients with intubation anesthesia (355) was smaller than the number with local anesthesia (584), the majority of patients with postoperative haemorrhage had been given intubation anesthesia (6). This difference corresponds to a trend (p = 0.089) towards a lower rate of postoperative haemorrhage with local anesthesia, which could encourage the surgeon to perform silicone oil removal under local anaesthesia. Over the course of time, there was a decline in postoperative haemorrhage. In 2002, 2005 and 2010 there were 7 cases of postoperative haemorrhage, but only 2 in the years 2014 - 2016. Aside from the higher proportion of operations under local anaesthesia, the decline in the frequency of postoperative haemorrhage may be attributed to "smoother extubation", the emergence of trocar-guided surgical procedure and the use of anti-VEGF therapy - all leading to a change in the spectrum of illnesses treated by silicone oil instillation.