Preliminary report: analgesia with Remifentanil for complicated eye muscle surgery

The authors report a new anesthetic technique that is especially suitable for the surgery of complicated disorders of ocular motility. Analgesia is achieved by an intravenous dose of Remifentanil, an opioid that is normally used together with propophol as a form of total intravenous anesthesia (TIVA) for general anesthesia. The advantage of Remifentanil is a rapid increase (1-2 min.) and decrease (3-4 min.) of the effect. Eye muscle surgery can then be performed on a patient who is free of pain and slightly sedated. After the planned eye muscle surgery, while the patient is still under anesthesia, the muscle sutures are tied provisionally. Afterwards, the squint angle can be measured with a cover test and the patient is questioned about the presence of diplopia. If the position of the eye is not satisfactory, the knots can be loosened and the muscle can be fixated in another position.