Dawson Charlotte, Sanchez Rick F
The Royal Veterinary College, Department of Clinical Science and Services, Hawkshead lane, North Mymms, Herts, AL9 7TA, UK.
Vet Ophthalmol. 2016 Mar;19(2):124-9. doi: 10.1111/vop.12272. Epub 2015 Mar 28.
To identify the prevalence of corneal ulceration in dogs receiving prophylactic gel lubrication under general anesthesia (GA).
An ophthalmic examination was performed before premedication and 24 h after GA in 100 dogs (199 eyes) undergoing nonophthalmic procedures. Individuals with known pre-existing ocular surface conditions were excluded. An ocular lubricating gel containing carmellose sodium was applied by the anesthetist at induction and every 2-4 h until extubation. Logistic regression analysis was used to calculate risk factors for ulcerative disease, including signalment, length of GA, patient position, procedure performed, pre-, and post-GA ophthalmic examination findings and admitting service. A Wilcoxon rank sum test compared pre- and post-GA Schirmer tear test-1 (STT-1) values.
One dog (0.5% of total eyes) developed fluorescein stain uptake consistent with superficial corneal ulceration that resolved within 48 h with supportive treatment. Twenty-five (18.6% of total eyes) developed a faint, patchy corneal uptake of stain in the axial cornea that was consistent with epithelial erosion. All erosions resolved with lubrication 24 h later. The decrease in STT-1 readings at 24 h post-GA was statistically significant from those pre-GA (P < 0.001). No significant risk factors for corneal erosion/ulceration were identified.
The results of this study show that a basic protocol of prophylactic lubrication during GA was associated with a low prevalence of corneal ulceration but a higher prevalence of epithelial erosion. In addition, the study supports the need for post-GA corneal examination.
确定在全身麻醉(GA)下接受预防性凝胶润滑的犬角膜溃疡的患病率。
对100只(199只眼)接受非眼科手术的犬在麻醉前及GA后24小时进行眼科检查。排除已知有眼部表面疾病的个体。麻醉师在诱导时及拔管前每2 - 4小时应用含羧甲基纤维素钠的眼部润滑凝胶。采用逻辑回归分析计算溃疡性疾病的危险因素,包括品种、GA时长、患者体位、所进行的手术、GA前后的眼科检查结果及收治科室。采用Wilcoxon秩和检验比较GA前后的泪液分泌试验-1(STT-1)值。
1只犬(占总眼数的0.5%)出现与浅表角膜溃疡一致的荧光素染色摄取,经支持治疗后48小时内消退。25只犬(占总眼数的18.6%)在角膜中央出现与上皮糜烂一致的淡片状角膜染色摄取。所有糜烂在24小时后通过润滑得以消退。GA后24小时STT-1读数较GA前显著降低(P < 0.001)。未发现角膜糜烂/溃疡形成的显著危险因素。
本研究结果表明,GA期间预防性润滑的基本方案与角膜溃疡的低患病率相关,但上皮糜烂的患病率较高。此外,该研究支持GA后进行角膜检查的必要性。