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Damage Control Ophthalmology: Anesthesia Considerations

  • Colonel Mark H. ChandlerEmail author
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Abstract

Safe and effective anesthetic management of ocular trauma remains an important skillset for the military anesthesiologist. Integral to this is a familiarity with ocular anatomy and physiology, particularly the factors affecting intraocular pressure. While regional and topical anesthesia is useful for minor eye procedures, general endotracheal anesthesia (GETA), particularly in the likely setting of accompanying facial trauma, remains the standard of care for most serious ocular trauma cases. Performing a general anesthetic for eye trauma, especially an open globe, requires a careful balance between creating ideal operating conditions, safeguarding the airway, and preventing the further deterioration of already compromised vision.

Keywords

Anesthesia Trauma Eye block Open globe Oculocardiac reflex Intraocular pressure Succinylcholine Retrobulbar block Peribulbar block Sub-Tenon block 

Abbreviations

ABC

Airway breathing circulation

ASA

American Society of Anesthesiologists

BETTS

Birmingham Eye Trauma Terminology System

cc

cubic centimeter

CN

Cranial nerve

ETT

Endotracheal tube

FDP

Face-down position

GETA

General endotracheal anesthesia

IED

Improvised explosive device

IOP

Intraocular pressure

JTTR

Joint Theater Trauma Registry

LA

Local anesthesia

MARCH

Massive hemorrhage, airway, respiration, circulation, head/hypothermia

mL

milliliter

NDMR

Nondepolarizing muscle relaxant

NPO

nil per os (nothing by mouth)

OCR

Oculocardiac reflex

PBB

Peribulbar block

RBB

Retrobulbar block

USA

United States of America

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.COL (RET), MC, Colorado Army National Guard, Department of AnesthesiologyDenver Health Medical CenterDenverUSA

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