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[The effect of general anesthesia on the position of the eye]
L Hromádková1, J Rehůrek, M Anton
1Dĕtská ocní klinika Fakultní dĕtské nemocnice, Brno.
Insights
Changes in eyeball position during anesthesia do not accurately predict strabismus surgery needs. The stretch test also proved unreliable for determining surgical dosage in pediatric strabismus cases.
Area of Science:
- Ophthalmology
- Anesthesiology
Context:
- Strabismus surgery in children requires precise preoperative assessment.
- General anesthesia can alter extraocular muscle tone and eye position.
Purpose:
- To evaluate if changes in eyeball position during general anesthesia, including the stretch test, can guide surgical strabismus operation magnitude.
- To compare anesthetic effects on eye position using nitrous oxide/halothane versus ketamine.
Summary:
- In 100 children undergoing strabismus surgery, eyeball position changes were observed during general anesthesia (92%) and were more pronounced with ketamine.
- The stretch test was normal in 73% and symmetrical in 93% of patients.
- Neither anesthesia-induced eye position changes nor the stretch test reliably predicted the required surgical dosage for concomitant strabismus.
Impact:
- Findings suggest current methods of assessing eye position under anesthesia are insufficient for optimizing strabismus surgery planning.
- Highlights the need for more reliable preoperative assessment tools in pediatric strabismus management.
Abstract:
In 100 children operated on account of strabismus the authors tried to assess whether changes in the position of the eyeballs during general anaesthesia with the stretch test can contribute towards the decision on the magnitude of the surgical operation. At the same time they compared changes in the position of the eyeballs during intubation anaesthesia by means of nitrous oxide and halothane with anaesthesia with ketamine, administered by the i.m. or i.v. route. They found that in 92% of the examined subjects the position of the eyeballs changed during general anaesthesia, most frequently the convergent deviation diminished. During ketamine anaesthesia the changes were more marked. The stretch test was in 73% of the patients normal, in 93% it was equal in both eyes. Based on the results, the authors conclude that neither the evaluation of changes of the eyeballs during general anaesthesia nor the stretch test can make the dosage of the surgical operation in concomitant strabismus more accurate.