Nitta Yukie, Kamekura Nobuhito, Takuma Shigeru, Fujisawa Toshiaki
Department of Dental Anesthesiology, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
Anesth Prog. 2014 Winter;61(4):162-4. doi: 10.2344/0003-3006-61.4.162.
Acute angle-closure glaucoma (AACG) is a rare complication of general anesthesia. The coexistence of individual risk factors for postoperative AACG and factors associated with intraocular hypertension are considered to be required for postoperative AACG to develop. We present a case of AACG after general anesthesia for oral bone grafting in a patient with no preoperative eye symptoms. In this case, several factors such as postoperative care in a darkened room, psychological stress, and postoperative hypertension may have precipitated the event in this patient, who may have had preexisting undiagnosed elevated intraocular pressure. The interval between the earliest appearance of symptoms at 9 hours and the ultimate diagnosis was 36 hours. In the postoperative period following general anesthesia, any patient is at risk for AACG. It is important that a postoperative diagnosis of AACG should be considered and a timely consultation with an ophthalmologist be considered if a postoperative patient complains of red eyes, visual disorder, eye pain, headache, and nausea.
急性闭角型青光眼(AACG)是全身麻醉的一种罕见并发症。术后AACG的发生被认为需要存在个体术后AACG危险因素以及与眼压升高相关的因素。我们报告一例在无术前眼部症状的患者进行口腔骨移植全身麻醉后发生AACG的病例。在该病例中,诸如在暗室中进行术后护理、心理压力和术后高血压等多种因素可能促使了该事件的发生,该患者可能原本就存在未被诊断出的眼压升高。最早症状出现于9小时,至最终确诊的间隔为36小时。在全身麻醉后的术后期间,任何患者都有发生AACG的风险。如果术后患者出现眼红、视力障碍、眼痛、头痛和恶心等症状,重要的是应考虑术后AACG的诊断并及时咨询眼科医生。