Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2018.01.008
Brazilian Journal of Anesthesiology
Scientific Article

Peribulbar block combined with general anesthesia in babies undergoing laser treatment for retinopathy of prematurity: a retrospective analysis

Bloqueio peribulbar combinado com anestesia geral em bebês submetidos a tratamento a laser para retinopatia da prematuridade: uma análise retrospectiva

Daniela Filipa Rodrigues Pinho; Cátia Real; Leónia Ferreira; Pedro Pina

http://dx.doi.org/10.1016/j.bjane.2018.01.008 Braz J Anesthesiol, vol.68, n5, p.431-436, 2018
PDF English
PDF Português
Downloads: 0
Views: 649

Abstract

Abstract Background and objectives Currently there is no agreement regarding which one is the most adequate anesthetic technique for the treatment of retinopathy of prematurity. Peribulbar block may reduce the incidence of oculocardiac reflex and postoperative apnea. The goal of this study was to report the outcomes of peribulbar block, when combined with general anesthesia, for the laser treatment for retinopathy of prematurity, in premature babies. Methods A retrospective analysis of anesthetic records of all babies who underwent laser treatment for retinopathy of prematurity from January 2008 through December 2015 in a tertiary hospital was performed. Results During that period a total of six babies was submitted to laser treatment for retinopathy of prematurity, all under peribulbar block combined with general anesthesia. A single infratemporal injection of 0.15 mL.kg−1 per eye ropivacaine 1% or 0.75% was performed. At the end of the procedure, all babies resumed spontaneous ventilation. No perioperative complications were reported. Conclusions Peribulbar block was a safe anesthetic technique in our sample considered.

Keywords

Retinopathy of prematurity, Nerve block, Retinal diseases, Infant, premature, Laser therapy

Resumo

Resumo Justificativa e objetivos Até o momento não há um consenso sobre a técnica anestésica mais adequada para o tratamento de retinopatia da prematuridade. O bloqueio peribulbar pode reduzir a incidência de reflexo oculocardíaco e apneia no pós-operatório. O objetivo deste estudo foi relatar os resultados do bloqueio peribulbar, quando combinado com anestesia geral, para o tratamento a laser de retinopatia da prematuridade em bebês prematuros. Métodos Uma análise retrospectiva dos registros anestésicos de todos os bebês submetidos ao tratamento a laser para retinopatia da prematuridade de janeiro de 2008 a dezembro de 2015 foi realizada em um hospital terciário. Resultados Durante esse período, seis bebês foram submetidos ao tratamento a laser para retinopatia da prematuridade, todos sob bloqueio peribulbar combinado com anestesia geral. Uma injeção infratemporal única de ropivacaína a 1% ou 0,75% (0,15 mL.kg−1) foi administrada por olho. No fim do procedimento, todos os bebês retomaram a ventilação espontânea. Não foram relatadas complicações perioperatórias. Conclusões O bloqueio peribulbar foi uma técnica anestésica segura em nossa amostra considerada.

Palavras-chave

Retinopatia da prematuridade, Bloqueio nervoso, Doenças retinianas, Recém-nascido, prematuro, Terapia a laser

References

Sinha R, Talawar P, Ramachandran R. Perioperative management and post-operative course in pre-term infants undergoing vitreo-retinal surgery for retinopathy of prematurity: a retrospective study. J Anaesthesiol Clin Pharmacol. 2014;30:258-62.

Walther-Larsen S, Rasmussen LS. The former preterm infant and risk of post-operative apnoea: recommendations for management. Acta Anaesthesiol Scand. 2006;50:888-93.

Sinha R, Maitra S. The effect of peribulbar block with general anesthesia for vitreoretinal surgery in premature and ex-premature infants with retinopathy of prematurity. A A Case Rep. 2016;6:25-7.

Rush R, Rush S, Nicolau J. Systemic manifestations in response to mydriasis and physical examination during screening for retinopathy of prematurity. Retina. 2004;24:242-5.

Jones LJ, Craven PD, Lakkundi A. Regional (spinal, epidural, caudal) versus general anesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy. Cochrane Database Syst Rev. 2015:CD003669.

James I. Anaesthesia for paediatric eye surgery. Contin Educ Anaesth Crit Care Pain J. 2008;8:5-10.

Subramaniam R, Subbarayudu S, Rewari V. Usefulness of pre-emptive peribulbar block in pediatric vitreoretinal surgery: a prospective study. Reg Anesth Pain Med. 2003;28:43-7.

Deb K, Subramaniam R, Dehran M. Safety and efficacy of peribulbar block as adjunct to general anaesthesia for paediatric ophthalmic surgery. Paediatr Anaesth. 2001;11:161-7.

Shende D, Sadhasivam S, Madan R. Effects of peribulbar bupivacaine as an adjunct to general anaesthesia on peri-operative outcome following retinal detachment surgery. Anaesthesia. 2000;55:970-5.

Gayer S, Palte H. Ultrasound guided ophthalmic regional anesthesia. Curr Opin Anesthesiol. 2016;29:655-61.

Stein ALS, Baumgard D, Del Rio I. Updates in pediatric regional anesthesia and its role in the treatment of acute pain in the ambulatory setting. Curr Pain Headache Rep. 2017;21:11.

Eipe N, Kim J, Ramsey G. Anesthesia for laser treatment for retinopathy of prematurity – all clear now?. Paediatr Anaesth. 2008;18:1103-5.

Knudsen K, Beckman Suurkula M, Blomberg S. Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers. Br J Anaesth. 1997;78:507-14.

Luz G, Wieser C, Innerhofer P. Free and total bupivacaine plasma concentrations after continuous epidural anaesthesia in infants and children. Paediatr Anaesth. 1998;8:473-8.

Maxwell LG, Martin LD, Yaster M. Bupivacaine-induced cardiac toxicity in neonates: successful treatment with intravenous phenytoin. Anesthesiology. 1994;80:682-6.

Mazoit JX, Dalens BJ. Pharmacokinetics of local anaesthetics in infants and children. Clin Pharmacokinet. 2004;43:17-32.

Bosenberg AT, Thomas J, Lopez T. Plasma concentrations of ropivacaine following a singleshot caudal block of 1, 2 or 3 mg/kg in children. Acta Anaesthesiol Scand. 2001;45:1276-80.

Lonnqvist PA, Westrin P, Larsson BA. Ropivacaine pharmacokinetics after caudal block in 1–8 year old children. Br J Anaesth. 2000;85:506-11.

Hong J, Han S, Kim W. A comparison of high volume/low concentration and low volume/high concentration ropivacaine in caudal analgesia for pediatric orchiopexy. Anesth Analg. 2009;109:1073-8.

Weintraud M, Lundblad M, Kettner SC. Ultrasound versus landmark-based technique for ilioinguinal-iliohypogastric nerve blockade in children: the implications on plasma levels of ropivacaine. Anesth Analg. 2009;108:1488-92.

Duke-Elder S. System of ophthalmology. 1963;vol. 3:310-2.

5dcb0d0e0e8825147703b87a rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections