Posters

Intraoperative and postoperative effects of pterygopalatine blockade as a component of regional anesthesia in congenital cataract surgery

Poster Details

First Author: O.Mishchenko RUSSIA

Co Author(s):    I. Oleshchenko   D. Zabolotskiy   T. Iureva   M. Gasparyan           

Abstract Details

Purpose:

Despite significant progress in the effectiveness and safety of modern phacoemulsification, the risks of development of operational and postoperative complications, the risks of the onset of the inflammatory process against the background of the physiological hyper reactivity of the child's organism for surgical trauma remain to this day. Modern ophthalmic surgery poses certain requirements for anesthesia, including the creation of optimal conditions for performing the operation, and the achievement of an extended nociceptive block by a single injection. Purpose: to evaluate the effectiveness of analgesic and anti-inflammatory effects of pterygopalatine blockade in the surgical treatment of cataract in children.

Setting:

S. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk, Russia St. Petersburg Pediatric Medical University

Methods:

A comparative analysis of the efficacy of the perioperative period was performed in 52 patients of two groups that were formed depending on the method of anesthesia. The first group (n=26) included patients who underwent a pterygopalatine blockade as a regional component of general anesthesia, the second (n=28) comparison group was formed from 28 patients undergoing retrobulbar blockade. To assess the adequacy of anesthesia, the concentration of plasma cortisol and oxidation-rehabilitation profile, the intensity of the pain syndrome were determined before and after the operation, the extent of the inflammatory reaction of the eye after surgery was assessed.

Results:

Results showed a decrease in the concentration of cortisol and an increase in the antioxidant capacity of the organism after surgery in patients of the first group. In patients of the 1st group, the Tyndal phenomenon of the 1st degree was revealed in 15.3% of cases. Each second patient of 2nd group had a moderate inflammatory reaction, in 7% of cases significant exudative phenomena were noted in the form of the Tyndall II degree phenomenon. After 18 months, secondary cataract developed in 11.5% in 1st group, and in 2nd group in 22%, which required the laser dissection of retrolental fibrosis.

Conclusions:

The use of pterygopalatine blockade as a component of combined anesthesia in the surgical treatment of cataracts allowed improving the quality of rehabilitation of a patient with congenital cataract, both in the early and late postoperative period.

Financial Disclosure:

None