Horikawa Hideyo, Matsuo Mitsuhiro, Yamazaki Mitsuaki
Department of Anesthesiology, Faculty of Medicine, University of Toyama, Toyama, Japan.
Department of Anesthesiology, Toyama Nishi General Hospital, Toyama, Japan.
Anesth Essays Res. 2022 Jul-Sep;16(3):392-396. doi: 10.4103/aer.aer_112_22. Epub 2022 Dec 9.
Routine tests before ophthalmologic surgery in adult patients are no longer recommended. However, there are limited data on the utility of routine preoperative tests for children.
We aimed to describe the effect of routine preoperative tests on systemic perioperative complications by hospital discharge or by day 30 following eye surgery.
This was a single-center, observational, and descriptive study.
We examined all patients ≤ 17 years old for whom ophthalmologists consulted with anesthesiologists before eye surgery under general anesthesia in an academic teaching tertiary care hospital from January 2010 to December 2019.
A total of 708 pediatric patients were analyzed. The mean patient age was 8.5 ± 4.6 years. The most frequently performed procedure was strabismus surgery in 433 patients (61.2%). Following anesthetic consultations, 15 patients (2.1%) underwent surgery postponed due to abnormalities at the physical examination. Routine tests identified that the two patients (0.3%) required additional evaluations due to elevated serum creatine kinase and electrocardiographic abnormalities. However, further examinations found that these abnormalities were unremarkable. The remaining 691 patients (97.6%) underwent surgery as scheduled. Substantial intraoperative blood loss was observed only in three patients with malignant tumors or trauma. The incidence of systemic complications was 0 (0%; 95% confidence interval, 0%-0.05%).
These data indicated that the development of systemic perioperative complications following pediatric ophthalmic surgery is rare. Preoperative tests should be requested only if they are clinically indicated or before potentially bleeding procedures, such as malignancy or trauma surgery.
不再推荐对成年患者进行眼科手术前的常规检查。然而,关于儿童术前常规检查效用的数据有限。
我们旨在描述常规术前检查对眼部手术后出院时或术后30天内全身性围手术期并发症的影响。
这是一项单中心、观察性和描述性研究。
我们检查了2010年1月至2019年12月期间在一家学术教学三级护理医院接受全身麻醉下眼科手术前眼科医生咨询麻醉医生的所有17岁及以下患者。
共分析了708例儿科患者。患者平均年龄为8.5±4.6岁。最常进行的手术是433例(61.2%)斜视手术。在麻醉咨询后,15例患者(2.1%)因体格检查异常而手术延期。常规检查发现2例患者(0.3%)因血清肌酸激酶升高和心电图异常需要进一步评估。然而,进一步检查发现这些异常并不显著。其余691例患者(97.6%)按计划进行了手术。仅在3例患有恶性肿瘤或创伤的患者中观察到术中大量失血。全身性并发症的发生率为0(0%;95%置信区间,0% - 0.05%)。
这些数据表明儿童眼科手术后全身性围手术期并发症的发生很少见。仅在临床有指征时或在可能出血的手术(如恶性肿瘤或创伤手术)前才应要求进行术前检查。