Department of Anesthesiology, Karadeniz Technical University Faculty of Medicine, Trabzon-Turkey.
Department of Neonatology, Karadeniz Technical University Faculty of Medicine, Trabzon-Turkey.
Ulus Travma Acil Cerrahi Derg. 2020 Sep;26(5):754-759. doi: 10.14744/tjtes.2020.62378.
Laser photocoagulation (LPC) is a surgical procedure used in the treatment of premature retinopathy that may cause retinal detachment and blindness if not diagnosed and treated early. The anesthesia method used in LPC varies from sedoanalgesia to general anesthesia and airway management varies from spontaneous ventilation to endotracheal intubation. In this study, we aimed to evaluate the effectiveness of sedoanalgesia applications and this anesthesia procedure concerning intraoperative and postoperative complications by avoiding intubation and mechanical ventilation in premature infants with a fragile population.
This retrospective study included 89 patients who underwent laser photocoagulation under anesthesia for premature retinopathy. Patients' demographic characteristics, preoperative risk factors, anesthesia technique, especially airway management, changes in ventilation status during surgery, intraoperative complications, postoperative complications, and intensive care follow-up, were recorded and analyzed statistically.
Two of the 89 patients who underwent laser photocoagulation were excluded from this study because they were followed up intubated. The number of patients who received mask ventilation due to intraoperative complications was 12 (13.8%). The mean operation time was 36.2±10.1 minutes. In 86.2% (n=75) of the patients, the surgical procedure was completed with sedoanalgesia while maintaining spontaneous ventilation.
Sedoanalgesia application during the surgical intervention of patients with Retinopathy of Prematurity (ROP) requiring early diagnosis and emergency treatment will minimize intraoperative and postoperative complications. We believe that sedoanalgesia as an anesthetic method can be applied as an effective alternative method while preserving spontaneous ventilation.
激光光凝术（LPC）是一种用于治疗早产儿视网膜病变的手术方法，如果不能早期诊断和治疗，可能会导致视网膜脱离和失明。LPC 中使用的麻醉方法从镇静镇痛到全身麻醉不等，气道管理从自主通气到气管插管不等。在这项研究中，我们旨在评估在避免早产儿气管插管和机械通气的情况下，镇静镇痛应用和这种麻醉程序在手术中和手术后并发症方面的有效性，早产儿人群脆弱。
这项回顾性研究包括 89 名因早产儿视网膜病变接受麻醉下激光光凝的患者。记录和统计分析患者的人口统计学特征、术前危险因素、麻醉技术，特别是气道管理、手术期间通气状态的变化、术中并发症、术后并发症以及重症监护随访。
在接受激光光凝的 89 名患者中，有 2 名患者因术后需要插管而被排除在本研究之外。由于术中并发症需要面罩通气的患者有 12 例（13.8%）。平均手术时间为 36.2±10.1 分钟。在 86.2%（n=75）的患者中，手术过程在维持自主通气的同时通过镇静镇痛完成。
在需要早期诊断和紧急治疗的早产儿视网膜病变（ROP）患者的手术干预中应用镇静镇痛将最大限度地减少手术中和手术后的并发症。我们相信，作为一种麻醉方法，镇静镇痛可以作为一种有效的替代方法，同时保留自主通气。
