Bhat Manjunath Timmappa, Hegde Harihar V, Santhosh M C B, Rao Raghavendra P
Department of Anesthesiology, SDM Medical College, Sattur, Dharwad, India.
Saudi J Anaesth. 2013 Oct;7(4):470-3. doi: 10.4103/1658-354X.121051.
Orbital exenteration is a disfiguring operation involving the removal of the entire contents of the orbit, with or without the eyelids. It is widely felt that such extensive surgery can only be performed under general anesthesia. We report our experience with a patient who underwent orbitalexenteration under trigeminal block with intravenous sedation. A 68-year-old male patient was diagnosed to have orbital cellulitis (mucormycosis), uncontrolled diabetes mellitus, ischemic heart disease, dilated cardiomyopathy with severe left ventricular systolic dysfunction with severe pulmonary artery hypertension, and nephropathy. We decided to avoid general anesthesia for such a high-risk patient with many co-morbid illnesses. We gave trigeminal block using a 22-G spinal needle with local anesthetic solution of bupivacaine 0.5% by classic approach. A standard exenteration was performed and the patient tolerated the procedure well with no complications.
眶内容剜除术是一种毁容性手术，需切除眼眶的全部内容物，可切除或不切除眼睑。人们普遍认为，这种大型手术只能在全身麻醉下进行。我们报告了一例在三叉神经阻滞联合静脉镇静下接受眶内容剜除术的患者的经验。一名68岁男性患者被诊断为眼眶蜂窝织炎（毛霉菌病）、未控制的糖尿病、缺血性心脏病、扩张型心肌病伴严重左心室收缩功能障碍及严重肺动脉高压和肾病。鉴于该高危患者合并多种疾病，我们决定避免使用全身麻醉。我们采用经典方法，使用22G脊椎穿刺针及0.5%布比卡因局部麻醉药溶液进行三叉神经阻滞。实施了标准的眶内容剜除术，患者对手术耐受良好，未出现并发症。
