眼内注气后视力丧失。
Visual loss following intraocular gas injection.
机构信息
Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen, Universitätsklinikum Essen, Hufelandstrasse 55, Essen.
出版信息
Dtsch Arztebl Int. 2008 Feb;105(6):108-12. doi: 10.3238/arztebl.2008.0108. Epub 2008 Feb 8.
INTRODUCTION
The range of indications for vitreoretinal surgery has widened in recent years, and intraocular gas application is frequently performed as part of retinal surgery, with the aim of achieving long-acting tamponade.
METHODS
Selective literature review.
RESULTS
An intraocular gas bubble containing perfluoropropane (C(3)F(8)) or sulfur hexafluoride (SF(6)) can expand during anesthesia due to nitrous oxide diffusion and cause retinal ischemia and postoperative blindness. A decrease in atmospheric pressure associated with travel to high altitude can have the same effect. Case reports suggest that, considering physical properties of these gases and ocular physiology, patients remain at risk for at least three months after intraocular gas application.
DISCUSSION
Both doctors and patients need to be well informed about the hazards of intraocular gas application as good communication may prevent complications. If in doubt, the anesthesiologist should avoid nitrous oxide, in particular in the unconscious patient.
简介
近年来，玻璃体视网膜手术的适应证范围不断扩大，眼内气体的应用已成为视网膜手术的常规操作，目的是实现长效的眼内填塞。
方法
选择性文献回顾。
结果
含全氟丙烷（C(3)F(8)）或六氟化硫（SF(6)）的眼内气泡会因一氧化二氮扩散而在麻醉期间膨胀，导致视网膜缺血和术后失明。与高海拔旅行相关的气压下降也会产生同样的效果。病例报告表明，考虑到这些气体的物理特性和眼部生理学，眼内气体应用后至少三个月内患者仍有风险。
讨论
医生和患者都需要充分了解眼内气体应用的危害，因为良好的沟通可以预防并发症。如果有疑问，麻醉师应避免使用一氧化二氮，特别是在无意识的患者中。
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