General anaesthesia for ophthalmic surgery

Abstract: Local anaesthesia for eye surgery is increasingly popular, but there will always be a need for general anaesthesia. Patients may refuse local anaesthesia, may be unable to keep still or lie flat for the duration of surgery or lack the mental facility to cooperate whilst awake. Young children and those with allergy to local anaesthetic also need general anaesthesia. Careful patient preparation is important before surgery. Glycaemic control in patients with diabetes, adjustments to warfarin or aspirin dosing, thromboembolic prophylaxis and preoperative fasting need to be considered. Eye surgery alone is rarely a true emergency, and surgery can usually wait until the patient’s stomach is empty. Eye pathology requiring surgery is a feature of many medical conditions and syndromes. Many patients are elderly with ischaemic heart disease, hypertension, chronic obstructive pulmonary disease and renal impairment, which must be assessed before general anaesthesia. Systemic effects of ophthalmic medications, such as hypokalaemia caused by acetazolamide should be considered. A wide range of general anaesthetic techniques are suitable for eye surgery, but certain key points are relevant to specific operations. These include the oculo-cardiac reflex in strabismus and retinal surgery, the use of intraocular gas bubbles in vitreo-retinal operations, controlled hypotension in lacrimal, orbital and other oculoplastic procedures, and the high incidence of nausea after strabismus...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Authors: Tags: Ophthalmic Anaesthesia Source Type: research

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Source: MDDI - Category: Medical Devices Authors: Tags: Cardiovascular Source Type: news
Authors: Ewy S, Pham H, Quan K, Su B, Tachdjian R Abstract Bullous pemphigoid (BP) is a rare blistering skin disease that is commonly treated with corticosteroids and immunosuppressive agents. Here, we present a 74-year-old woman with severe BP following a leg fracture who was successfully treated with omalizumab. We started her on a regimen of omalizumab 300 mg subcutaneously every 4 weeks, and within a week she reported significantly decreased pain and faster healing time of lesions. Incidentally, bilateral erythematous, non-blistering dermatitis developed 5 centimeters distal to the injection sites within a week...
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research
We present a patient with refractory neuropathic pain in a normotrophic spread-scar treated with the injection of BTA. A 47-year-old Caucasian female with a history of invasive melanoma of the left upper arm presented with pain in her excision scar, which she described as a “pins and needles” sensation alternating with a dull, deep ache. She had previously tried topical lidocaine, topical and intralesional steroids, and oral gabapentin without improvement. We treated the patient with 50 U of onabotulinumtoxinA intradermally at 1-1.5 cm intervals within and immediately around the perimeter of the scar. At 1-wee...
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research
CONCLUSION: There is considerable variation in PLLA reconstitution and use. Further well-designed studies are needed to establish the safest, most effective ways to use this product. J Drugs Dermatol. 2019;18(9):880-886. PMID: 31524343 [PubMed - in process]
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research
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Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research
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Source: Biomed Res - Category: Research Authors: Tags: Adv Biomed Res Source Type: research
Is there an increased risk of developing de novo inflammatory bowel disease while under treatment with anti-TNF-alpha for other chronic inflammatory or immune-mediated diseases?Alimentary Pharmacology &Therapeutics
Source: Medscape Allergy Headlines - Category: Allergy & Immunology Tags: Gastroenterology Journal Article Source Type: news
CONCLUSIONS Arthroscopic superior capsule reconstruction currently appears to be the method of choice in unreconstructed supraspinatus and infraspinatus tear. Our group of patients shows that early clinical outcomes of SCR using xenograft are very promising. A significant pain relief and a considerable improvement in the range of motion of the operated shoulder joint were observed. No complication specifically associated with the use of xenograft has been reported as yet. A longer follow-up period and assessment of a larger group of patients will be necessary to confirm the success of this surgical procedure. Key words: ma...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Chir Orthop Traumatol Cech Source Type: research
Rosenbaum J Abstract PURPOSE OF THE STUDY Lumbar spinal stenosis (LSS) is a serious and fairly frequent disorder with prevalence increasing with age which often results in a disability. The surgical procedures are often very risky due to the greater age of patients with severe stenosis and their comorbidities. The study aimed to assess the functional outcomes and complications in patients who underwent surgical treatment for LSS at one year postoperatively and to identify the differences in the functional outcomes, if any, in dependence on the number of operated segments. MATERIAL AND METHODS It was a prospective ...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Chir Orthop Traumatol Cech Source Type: research
aacute;č P Abstract The team of authors presents a case of the patient who suffered an isolated unstable extra-articular distal ulnar fracture, the surgical treatment of which was affected by a postponed management in consequence of inadequate primary treatment. The primary non-operative treatment resulted in a complex malunion ad latus, ad axim and ad peripheriam. The malunion which led to a painful restricted range of motion of the forearm (59%), decreased hand grip strength and significant limitation of activities of daily living was surgically treated by a triplane corrective osteotomy at 11 months after inju...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Chir Orthop Traumatol Cech Source Type: research
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