Abramson David H, Liu Todd, Guarini Edith, Gaccione Jacquelyn, Bracken Christina, Bobin Andrea, Foerch Angela, Robbins Melissa A, Rojas Ricardo Dodds, Francis Jasmine H
Ophthalmic Oncology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Weill Cornell Medical College, New York, NY, USA.
Asia Pac J Oncol Nurs. 2024 Jun 20;11(8):100543. doi: 10.1016/j.apjon.2024.100543. eCollection 2024 Aug.
The pupils of children with retinoblastoma are routinely dilated pre-procedure with Tropicamide and Phenylephrine. Despite that, the pupil constricts once general anesthesia begins. The aim of this study is to see if adding Ketorolac to the regular dilating drops given pre-procedure shortens the length of anesthesia.
Retrospective comparison of time under anesthesia for two groups of retinoblastoma children receiving anesthesia for examination under anesthesia: one group (January 1, 2019 to October 1, 2022) had been dilated with Tropicamide 1% and Phenylephrine 2.5% while the second group (October 2, 2022 to July 1, 2023) was dilated with a combination drop using those drugs with topical Ketorolac 0.5% and Proparacaine 0.5%.
Average anesthesia time for patients who received the older two-drug combination was 25 minutes vs. 16 minutes (36% reduction in exposure time) for those who received the newer four-drug combination (9 minutes less anesthesia) ( < 0.001).
The use of a combined dilating drop that incorporated Tropicamide 1%, Phenylephrine 2.5%, Proparacaine 0.5% and Ketorolac 0.5% significantly shortened the time for exams under anesthesia for children with retinoblastoma because the pupil remained dilated after anesthesia induction with Sevoflurane. Using this combined drop, children will receive 5-10 hours less anesthesia during their treatment for retinoblastoma and staff will have more than 150 hours of fewer exposure to anesthetic gasses. In addition, far fewer drops are necessary pre-anesthesia, minimizing trauma to the children and families.
视网膜母细胞瘤患儿在手术前常规使用托吡卡胺和去氧肾上腺素散瞳。尽管如此，一旦开始全身麻醉，瞳孔就会收缩。本研究的目的是观察在术前常规散瞳滴眼液中添加酮咯酸是否能缩短麻醉时间。
对两组接受麻醉下检查的视网膜母细胞瘤患儿的麻醉时间进行回顾性比较：一组（2019年1月1日至2022年10月1日）使用1%托吡卡胺和2.5%去氧肾上腺素散瞳，而第二组（2022年10月2日至2023年7月1日）使用含0.5%酮咯酸和0.5%丙美卡因的上述药物混合滴眼液散瞳。
接受旧的两药组合的患者平均麻醉时间为25分钟，而接受新的四药组合的患者平均麻醉时间为16分钟（暴露时间减少36%）（麻醉时间少9分钟）（P<0.001）。
使用含1%托吡卡胺、2.5%去氧肾上腺素、0.5%丙美卡因和0.5%酮咯酸的混合散瞳滴眼液可显著缩短视网膜母细胞瘤患儿麻醉下检查的时间，因为使用七氟醚诱导麻醉后瞳孔仍保持散大。使用这种混合滴眼液，患儿在视网膜母细胞瘤治疗期间接受的麻醉时间将减少5至10小时，医护人员接触麻醉气体的时间将减少150多个小时。此外，麻醉前所需的滴眼液数量大大减少，将对患儿及其家庭的创伤降至最低。
