Name of the Procedure:

Anesthesia for procedures on eye; vitreoretinal surgery

• Common name: Eye anesthesia for retinal surgery
• Technical name: Anesthesia for vitreoretinal surgery

Summary

Anesthesia for vitreoretinal surgery involves administering medication to prevent pain and ensure patient comfort during surgical procedures on the retina and vitreous parts of the eye.

Purpose

The anesthesia ensures that the patient does not experience pain during the vitrectomy or other retinal surgeries. Its goals are to provide a pain-free surgical experience, minimize patient anxiety, and allow the surgeon to perform delicate operations on the eye without hindrance.

Indications

• Retinal detachment
• Macular hole
• Diabetic retinopathy complications
• Vitreous hemorrhage
• Epiretinal membrane

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Blood tests and a thorough medical assessment will be conducted.
• Patients should disclose all medications and any allergies to their healthcare provider.
• Adjustments to current medications, particularly anticoagulants and antiplatelet drugs, may be necessary.

Procedure Description

1. The patient is positioned comfortably on the surgical bed.
2. Local anesthesia (via injections around the eye) or general anesthesia may be administered based on the patient's needs and the complexity of the surgery.
3. Monitoring devices are attached to observe vitals like heart rate, blood pressure, and oxygen levels.
4. Under the effect of anesthesia, the surgeon proceeds with the vitreoretinal surgery, which may involve the removal of vitreous gel and repairing the retina.
5. The anesthesia team adjusts medication levels as necessary throughout the procedure.

Duration

The duration of anesthesia administration usually takes about 30 minutes, while the entire vitreoretinal surgery can last between 1 to 3 hours, depending on the complexity.

Setting

The procedure is typically performed in a hospital's operating room or a specialized surgical center.

Personnel

• Anesthesiologists
• Retinal surgeons
• Ophthalmic nurses
• Surgical technicians

Risks and Complications

• Anesthesia-related reactions (allergic reactions, respiratory issues)
• Intraoperative awareness (very rare under general anesthesia)
• Potential for infection at the injection site
• Temporary blurred vision post-surgery
• Elevated eye pressure
• Bleeding inside the eye

Benefits

• Complete pain relief during surgery
• Reduced stress and anxiety for the patient
• Facilitates precise and successful surgical outcomes
• Postoperative pain management and quicker recovery

Recovery

• Patients are monitored in a recovery room until they regain full consciousness and vitals stabilize.
• Postoperative care may include the use of eye drops, antibiotics, and pain relievers.
• The typical recovery timeline can vary from a few days to several weeks, with specific instructions provided by the surgeon regarding activity limitations and follow-up visits.

Alternatives

• Sedation without full general anesthesia
• Nerve blocks might be an option for less extensive procedures
• Non-surgical treatments or observational management in minor cases
• Each alternative has its own risks and benefits; the choice depends on the patient's health status and the severity of the eye condition.

Patient Experience

During the procedure, patients under local anesthesia may be aware of the lights and sounds but should not feel pain. For those under general anesthesia, the experience will involve being completely unconscious. Post-surgery, there may be mild discomfort or a feeling of pressure in the operated eye, easily managed with prescribed pain relief medications.