Anesthesia for ophthalmologic surgery

This chapter takes a look at the special challenges of conducting an anesthetic for ophthalmologic procedures. These cases carry the important responsibility of preserving patient vision and maintaining patient comfort and safety. It is no easy task performing these procedures under minimal sedation in a uniquely challenging patient population where extremes of age, multiple comorbidities, traumas, and communication deficits are rampant. The anesthesiologist has to continually balance the ability to control intraocular pressure, prevent arrhythmias, control gas bubble expansion and maintain adequate analgesia and akinesia. Various surgeries can be carried out by a variety of regional techniques with supplementation from topical, local or general anesthesia. It answers the difficult question of whether retrobulbar, peribulbar, or sub-Tenon's blocks individually carry any distinct advantages as well as examine their various side effects and complications. It will examine ocular anatomy, the physiology of anesthetic drugs, and sometimes-dangerous consequences of ocular medications these patients may be taking. It will prepare any provider for adequate vigilance during monitoring, detection of the oculocardiac reflex, and prompt treatment and resolution of such arrhythmias.