ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

OPHTHALMIC AND EAR, NOSE, THROAT SURGERY ANESTHESIA

Mustafa Büyükcavlak

Konya City Hospital, Department of Anesthesiology and Reanimation, Konya, Türkiye

Büyükcavlak M. Ophthalmic and Ear, Nose, Throat Surgery Anesthesia. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.379-389.

ABSTRACT

  • Intraocular pressure must be carefully managed to prevent surgical complications.
  • Systemic effects of ophthalmic medications should be considered in anesthesia planning.
  • The choice between regional and general anesthesia depends on the type of ophthalmic surgery.
  • The oculocardiac reflex should be anticipated and promptly managed during eye surgeries.
  • Airway management in ENT surgery requires thorough preoperative assessment and planning.
  • Laser-based procedures pose a fire risk, requiring strict adherence to safety protocols and preparedness for emergency response.
  • Intraoperative and postoperative airway complications may complicate ENT surgery anesthesia due to sharing the airway with the surgical team and possible effects on the airway due to regional proximity of specific operations.
  • Postoperative nausea and vomiting should be prevented using multimodal strategies.
  • Nitrous oxide should be avoided in retinal surgeries and certain ENT procedures.
  • Controlled hypotension techniques help minimize intraoperative bleeding in ENT surgeries.

Keywords: Anesthesia; Ophthalmic administration; Airway management; Preoperative period; Ear middle

Referanslar

  1. Yarwood J, Bartholomew K. Systemic effects of topical ophthalmic agents. BJA: British Journal of Anaesthesia. 2010;105(2):238-239. [Crossref]  [PubMed]
  2. Murgatroyd H, Bembridge J. Intraocular pressure. Continuing Education in Anaesthesia Critical Care & Pain. 2008;8(3):100-103. [Crossref]
  3. Cunningham AJ, Barry PJCASJ. Intraocular pressure-physiology and implications for anaesthetic management. 1986;33:195-208. [Crossref]  [PubMed]
  4. Kazancıoğlu L, Batçık Ş, Kazdal H, Şen A, Gediz B, Erdivanlı B. Complication of Peribulbar Block: Brainstem Anaesthesia. Turkish journal of anaesthesiology and reanimation. 2017;45(4):231-233. [Crossref]  [PubMed]  [PMC]
  5. Arnold RW. The Oculocardiac Reflex: A Review. Clinical ophthalmology (Auckland, NZ). 2021;15:2693-2725. [Crossref]  [PubMed]  [PMC]
  6. Kelly DJ, Farrell SM. Physiology and Role of Intraocular Pressure in Contemporary Anesthesia. 2018;126(5):1551-1562. [Crossref]  [PubMed]
  7. Douketis JD. Perioperative management of patients who are receiving warfarin therapy: an evidence-based and practical approach. Blood. 2011;117(19):5044-5049. [Crossref]  [PubMed]
  8. Jung YH. Anesthetic management of ophthalmic surgery. Korean J Anesthesiol. 2009;57(5):553-559. [Crossref]  [PubMed]
  9. Malik A, Fletcher EC, Chong V, Dasan J. Local anesthesia for cataract surgery. Journal of Cataract & Refractive Surgery. 2010;36(1):133-152. [Crossref]  [PubMed]
  10. Izquierdo MA, Prokopius M. Retrobulbar Block and Associated Complications. In: Lovich-Sapola JA, editor. Anesthesia Oral Board Review: Knocking Out The Boards. 2nd ed. Cambridge: Cambridge University Press; 2023;.440-2. [Crossref]
  11. Mavrakanas NA, Stathopoulos C, Schutz JSJCoio. Are ocular injection anesthetic blocks obsolete? Indications and guidelines. 2011;22(1):58-63. [Crossref]  [PubMed]
  12. Kumar CM, Eid H, Dodds C. Sub-Tenon's anaesthesia: complications and their prevention. Eye. 2011;25(6):694-703. [Crossref]  [PubMed]  [PMC]
  13. Naik MP, Sethi HS, Yadav A. Topical vs Peribulbar Anesthesia: Comparison of Anterior Chamber Depth and the Resultant Visual Outcome After Phacoemulsification. Clinical ophthalmology (Auckland, NZ). 2020;14:3775-3780. [Crossref]  [PubMed]  [PMC]
  14. Lee EJK. Use of nitrous oxide causing severe visual loss 37 days after retinal surgery. BJA: British Journal of Anaesthesia. 2004;93(3):464-466. [Crossref]  [PubMed]
  15. Ellard L, Wong DT. Anesthesia for airway panendoscopy. In: Abdelmalak B, Doyle J, eds. Anesthesia for Otolaryngologic Surgery. 1st ed. Cambridge: Cambridge University Press; 2012;228-36. [Crossref]
  16. Li LT, Chitilian HV, Alfille PH, Bao X. Airway management and anesthesia for airway surgery: a narrative review. Translational lung cancer research. 2021;10(12):4631-4642. [Crossref]  [PubMed]  [PMC]
  17. Rosenblatt W, Ianus AI, Sukhupragarn W, Fickenscher A, Sasaki C. Preoperative Endoscopic Airway Examination (PEAE) Provides Superior Airway Information and May Reduce the Use of Unnecessary Awake Intubation. 2011;112(3):602-607. [Crossref]  [PubMed]
  18. Zhu CL, Zhou M, Hu YC, et al. Difficult airway management in patients with laryngeal tumor: Case series and systematic review. Perioper Precis Med. 2024;2(2):36-43. [Link]
  19. Samal S, Pattnaik SK, Swain N, Jena SKJAJPCR. Dexmedetomidine versus oral pregabalin to attenuate hemodynamic response to laryngoscopy and orotracheal intubation: a comparative study. 2017;10(5):258-260. [Crossref]
  20. Robinson M, Davidson A. Aspiration under anaesthesia: risk assessment and decision-making. Continuing Education in Anaesthesia Critical Care & Pain. 2013;14(4):171-175. [Crossref]
  21. Yan Y, Olszewski AE, Hoffman MR, Zhuang P, Ford CN, Dailey SH, et al. Use of Lasers in Laryngeal Surgery. Journal of Voice. 2010;24(1):102-109. [Crossref]  [PubMed]  [PMC]
  22. Babinski, M, Smith RB, Klain M. High-Frequency Jet Ventilation for Laryngoscopy. Survey of Anesthesiology. 1981;25(1):19-20. [Crossref]
  23. Evans E, Biro P, Bedforth N. Jet ventilation. Continuing Education in Anaesthesia Critical Care & Pain. 2007;7(1):2-5. [Crossref]
  24. Borland LMJIac. Airway management for CO2 laser surgery on the larynx: Venturi jet ventilation and alternatives. 1997;35(3):99-106. [Crossref]  [PubMed]
  25. Bagle A, Raj A, Gaur S, Singh C, Kale AJC. Battle of the Gases: How Air and Nitrous Oxide Affect Endotracheal Tube Cuff Pressure During General Anesthesia. 2024;16(8). [Crossref]  [PubMed]
  26. Buczkowski PW, Fombon FN, Russell WC, Thompson JP. Effects of helium on high frequency jet ventilation in model of airway stenosis. British Journal of Anaesthesia. 2005;95(5):701-705. [Crossref]  [PubMed]
  27. Sheinbein DS, Loeb RG. Laser Surgery and Fire Hazards in Ear, Nose, and Throat Surgeries. Anesthesiology Clinics. 2010;28(3):485-496. [Crossref]  [PubMed]
  28. Graham ME, Neal AK, Newberry IC, Firpo MA, Park AH. Conscious Sedation for Pediatric Peritonsillar Abscess: Comparison of Anesthetic Approaches. Otolaryngology-Head and Neck Surgery. 2019;160(4):706-711. [Crossref]  [PubMed]
  29. Bangera A. Anaesthesia for adenotonsillectomy: An update. Indian J Anaesth. 2017;61(2):103-109. [Crossref]  [PubMed]  [PMC]
  30. Barst SM, Markowitz A, Yossefy Y, Abramson A, Lebowitz P, Bienkowski RS. Propofol reduces the incidence of vomiting after tonsillectomy in children. Paediatr Anaesth. 1995;5(4):249-252. [Crossref]  [PubMed]
  31. Liang S, Irwin MG. Review of Anesthesia for Middle Ear Surgery. Anesthesiology Clinics. 2010;28(3):519-528. [Crossref]  [PubMed]
  32. Düzenli U, Bozan N, Turan M, Ağırbaş S, Tekeli AE, Kıroğlu AF. The Effect of Nitrous Oxide on the Outcomes of Underlay Tympanoplasty: A Prospective Study. Ear Nose Throat J. 2019 Dec;98(10):621-624. [Crossref]  [PubMed]
  33. Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2020;131(2):411-448. [Crossref]  [PubMed]
  34. Li, J. Anesthesia for Nasal and Antral Surgery. In: Jiang H., Xia M. eds. Anesthesia for Oral and Maxillofacial Surgery. 1st ed. Singapore: Springer; 2023;257-71. [Crossref]
  35. Galway U, Alam D. Anesthesia for septoplasty and rhinoplasty. In: Abdelmalak B, Doyle J, eds. Anesthesia for Otolaryngologic Surgery. 1st ed. Cambridge: Cambridge University Press; 2012;113-20. [Crossref]
  36. Chadha NK, Repanos C, Carswell AJ. Local anaesthesia for manipulation of nasal fractures: systematic review. The Journal of Laryngology & Otology. 2009;123(8):830-836. [Crossref]  [PubMed]
  37. Healy DW, Bradford CR. Anesthesia for neck dissection and laryngectomy. In: Abdelmalak B, Doyle J. eds. Anesthesia for Otolaryngologic Surgery. 1st ed. Cambridge: Cambridge University Press; 2012;143-50. [Crossref]
  38. Savvas E, Hillmann S, Weiss D, Koopmann M, Rudack C, Alberty J. Association between facial nerve monitoring with postoperative facial paralysis in parotidectomy. 2016;142(9):828-833. [Crossref]  [PubMed]
  39. Perilla M, Lei B, Alam D. Anesthesia for parotid surgery. In: Abdelmalak B, Doyle J. eds. Anesthesia for Otolaryngologic Surgery. 1st ed. Cambridge: Cambridge University Press; 2012;203-9. [Crossref]