Wright E L, Kossick M A
Brookwood Medical Center, Birmingham, Ala., USA.
AANA J. 2000 Feb;68(1):73-83.
Anesthesia for the patient with a perforated globe can be complicated. Cognizance of the anatomy and physiology of the eye, including maintenance of intraocular pressure, is essential for the development of an anesthetic plan. Since the induction phase of anesthesia is the most critical period during which intraocular pressure is affected, understanding the pharmacology of the various anesthetic agents and their effects on the eye is important. To avoid increasing intraocular pressure, a smooth, atraumatic induction is desired. However, methods to achieve this end may place the patient at risk for aspiration. Various techniques that attempt to accomplish this goal are described, including the use of narcotics, lidocaine, nitroglycerin, alpha (alpha 2) agonism, beta (beta) adrenergic and calcium channel blockades, plus the laryngeal mask airway.
对于眼球穿孔患者的麻醉可能会很复杂。了解眼睛的解剖结构和生理功能，包括眼内压的维持，对于制定麻醉计划至关重要。由于麻醉诱导期是眼内压受影响的最关键时期，了解各种麻醉药物的药理学及其对眼睛的影响很重要。为避免眼内压升高，需要平稳、无创的诱导。然而，实现这一目的的方法可能会使患者面临误吸风险。文中描述了试图实现这一目标的各种技术，包括使用麻醉剂、利多卡因、硝酸甘油、α（α2）激动剂、β（β）肾上腺素能和钙通道阻滞剂，以及喉罩气道。
