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Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
[Pulmonary edema after topic phenylephrine absorption during pediatric eye surgery: case report.]
Maria de Fátima Savioli Fischer1, Eduardo Toshiyuki Moro, Válter Moreno Guasti
1Hospitais Santa Lucinda e UNIMED.
Revista Brasileira De Anestesiologia
|May 28, 2009
Summary
Topical phenylephrine eyedrops can cause severe hypertension and pulmonary edema during eye surgery. Anesthesiologists must be informed to prevent systemic absorption and manage potential complications with vasodilators or alpha-blockers.
Area of Science:
- Ophthalmology
- Anesthesiology
- Pharmacology
Context:
- Topical phenylephrine is frequently used in ophthalmic procedures for decongestion and mydriasis.
- Systemic absorption of phenylephrine eyedrops can lead to significant cardiovascular complications.
- This case highlights a severe reaction during strabismus correction.
Purpose:
- To report a case of severe hypertension and pulmonary edema following topical phenylephrine administration.
- To discuss preventive strategies against phenylephrine-induced systemic absorption.
- To outline appropriate management for this complication.
Summary:
- A 12-year-old male developed refractory hypertension, tachycardia, and acute pulmonary edema after receiving topical 10% phenylephrine during strabismus surgery.
- Initial management with increased anesthetic depth and droperidol was ineffective.
- Cardiovascular parameters stabilized with sevoflurane, and pulmonary edema resolved after furosemide administration.
Impact:
- Emphasizes the need for caution when administering topical phenylephrine before surgery.
- Highlights the importance of anesthesiologist awareness for proactive management.
- Suggests direct vasodilators or alpha-blockers as preferred treatments for phenylephrine-induced hypertension.
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