Cataract surgery - Revision history

Jashvin at 02:22, 12 September 2024

2024-09-12T02:22:09Z

← Older revision		Revision as of 19:22, 11 September 2024
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	=== Second Eye Effect ===		=== Second Eye Effect ===
	* Patients report more unpleasant experience with their second eye surgery.		* Patients report more unpleasant experience with their second eye surgery.
	*Before the surgery on their second eye, patients report less anxiety and have higher expectations. However, almost 50% of patients say that their second eye was less pleasant compared to their first.		*Before the surgery on their second eye, patients report less anxiety and have higher expectations. However, almost 50% of patients say that their second eye was less pleasant compared to their first. <ref>{{Cite web\|date=2015-02-25\|title=Study confirms “second eye” effect in cataract surgery\|url=https://www.aao.org/education/editors-choice/study-confirms-differences-in-patients-subjective-\|access-date=2024-09-12\|website=American Academy of Ophthalmology\|language=en}}</ref>
	*This may be due to an "expectation gap"		*This may be due to an "expectation gap"

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	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
	<references />''2. Study confirms ‘Second eye’ effect in cataract surgery'' (2015) ''American Academy of Ophthalmology''. Available at: <nowiki>https://www.aao.org/education/editors-choice/study-confirms-differences-in-patients-subjective-</nowiki> (Accessed: 11 September 2024).		<references />
	[[Category:Ophthalmology]]		[[Category:Ophthalmology]]

Jashvin: second eye effect

2024-09-12T02:21:13Z

second eye effect

← Older revision		Revision as of 19:21, 11 September 2024
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	* Oculocardiac reflex, caused by traction on extraocular muscles, can result in rapid decrease in heart rate and blood pressure.		* Oculocardiac reflex, caused by traction on extraocular muscles, can result in rapid decrease in heart rate and blood pressure.
	** Stop surgical manipulation, give [[atropine]]/[[glycopyrrolate]]		** Stop surgical manipulation, give [[atropine]]/[[glycopyrrolate]]

			=== Second Eye Effect ===
			* Patients report more unpleasant experience with their second eye surgery.
			*Before the surgery on their second eye, patients report less anxiety and have higher expectations. However, almost 50% of patients say that their second eye was less pleasant compared to their first.
			*This may be due to an "expectation gap"

	===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===		===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===
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	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
	<references />		<references />''2. Study confirms ‘Second eye’ effect in cataract surgery'' (2015) ''American Academy of Ophthalmology''. Available at: <nowiki>https://www.aao.org/education/editors-choice/study-confirms-differences-in-patients-subjective-</nowiki> (Accessed: 11 September 2024).
	[[Category:Ophthalmology]]		[[Category:Ophthalmology]]

Chris.Rishel at 07:42, 5 April 2022

2022-04-05T07:42:57Z

← Older revision		Revision as of 00:42, 5 April 2022
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	{{Infobox surgical case reference		{{Infobox surgical case reference
	\| anesthesia_type = MAC		\| anesthesia_type = MAC
	\| airway = ~~Nasal Canula~~		\| airway = Noninvasive O2
	\| lines_access = Peripheral IV		\| lines_access = Peripheral IV
	\| monitors = Standard ~~ASA /~~ 5 ~~Lead EKG~~		\| monitors = Standard
			5-lead ECG
	\| considerations_preoperative =		\| considerations_preoperative =
	\| considerations_intraoperative = Dysrhythmias, Oculocardiac ~~Reflex~~		\| considerations_intraoperative = Dysrhythmias
			Oculocardiac reflex
	\| considerations_postoperative =		\| considerations_postoperative =
	}}		}}

Chris.Rishel: Text replacement - "|Respiratory" to "|Pulmonary"

2022-02-22T05:44:27Z

Text replacement - "|Respiratory" to "|Pulmonary"

← Older revision		Revision as of 22:44, 21 February 2022
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	\|		\|
	\|-		\|-
	\|~~Respiratory~~		\|Pulmonary
	\|		\|
	* Patients with chronic cough may warrant general anesthesia.		* Patients with chronic cough may warrant general anesthesia.

Chris.Rishel at 21:07, 21 February 2022

2022-02-21T21:07:36Z

← Older revision		Revision as of 14:07, 21 February 2022
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	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
			<references />
			[[Category:Ophthalmology]]

Tony.Wang: links

2021-11-29T16:02:20Z

links

← Older revision		Revision as of 09:02, 29 November 2021
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	* If any cautery is used, the delivered FiO2 < 30%		* If any cautery is used, the delivered FiO2 < 30%
	* Oculocardiac reflex, caused by traction on extraocular muscles, can result in rapid decrease in heart rate and blood pressure.		* Oculocardiac reflex, caused by traction on extraocular muscles, can result in rapid decrease in heart rate and blood pressure.
	** Stop surgical manipulation, give atropine/glycopyrrolate		** Stop surgical manipulation, give [[atropine]]/[[glycopyrrolate]]

	===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===		===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===

Tony.Wang: OR room setup

2021-11-29T16:01:51Z

OR room setup

← Older revision		Revision as of 09:01, 29 November 2021
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	===Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. -->===		===Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. -->===

			* N/A

	===Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. -->===		===Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. -->===

			* Nasal cannula
			* Drape retractor for comfort (optional)

	===Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. -->===		===Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. -->===

			* N/A

	===Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. -->===		===Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. -->===

	* Retrobulbar or sub-tenon block can be used in procedure room and OR environments		* Retrobulbar or sub-tenon block can be used in procedure room and OR environments

	==Intraoperative management==		==Intraoperative management==
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	* Coughing or valsalva should be avoided as much as possible		* Coughing or valsalva should be avoided as much as possible
	* If any cautery is used, the delivered FiO2 < 30%		* If any cautery is used, the delivered FiO2 < 30%
	* Oculocardiac reflex, caused by traction on extraocular muscles, can result in rapid decrease in heart rate and blood pressure.		* Oculocardiac reflex, caused by traction on extraocular muscles, can result in rapid decrease in heart rate and blood pressure.
	** Stop surgical manipulation, give atropine/~~glycopyrolate~~		** Stop surgical manipulation, give atropine/glycopyrrolate

	===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===		===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===

Chris.Rishel: Fix reference

2021-07-09T09:51:13Z

Fix reference

← Older revision		Revision as of 02:51, 9 July 2021
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	* Nasal cannula is commonly used for oxygen supplementation		* Nasal cannula is commonly used for oxygen supplementation
	* Patients are usually awake and alert during procedure, with topical medication commonly administered to operative eye		* Patients are usually awake and alert during procedure, with topical medication commonly administered to operative eye
	* Lidocaine-propofol-alfentanil mixtures<ref>{{Cite journal\|last=Fang\|first=Zhuang T.\|last2=Keyes\|first2=Mary A.\|date=2006~~-03-XX~~\|title=A novel mixture of propofol, alfentanil, and lidocaine for regional block with monitored anesthesia care in ophthalmic surgery\|url=https://linkinghub.elsevier.com/retrieve/pii/S0952818005003508\|journal=Journal of Clinical Anesthesia\|language=en\|volume=18\|issue=2\|pages=114–117\|doi=10.1016/j.jclinane.2005.08.007}}</ref> can be used for induction during application of retrobulbar or sub-tenon blocks by proceduralist		* Lidocaine-propofol-alfentanil mixtures<ref>{{Cite journal\|last=Fang\|first=Zhuang T.\|last2=Keyes\|first2=Mary A.\|date=2006\|title=A novel mixture of propofol, alfentanil, and lidocaine for regional block with monitored anesthesia care in ophthalmic surgery\|url=https://linkinghub.elsevier.com/retrieve/pii/S0952818005003508\|journal=Journal of Clinical Anesthesia\|language=en\|volume=18\|issue=2\|pages=114–117\|doi=10.1016/j.jclinane.2005.08.007\|via=}}</ref> can be used for induction during application of retrobulbar or sub-tenon blocks by proceduralist
	* Benzodiazapenes (ex. midazolam) and opioids (ex. fentanyl) are commonly administered throughout the case as needed for patient comfort		* Benzodiazapenes (ex. midazolam) and opioids (ex. fentanyl) are commonly administered throughout the case as needed for patient comfort
	* Placement of retrobulbulbar or peribulbar blocks can be briefly very painful - consider remifentanil (0.25-1mcg/kg), alfentanil (5-7mcg/kg), or propofol bolus (30-50mg)		* Placement of retrobulbulbar or peribulbar blocks can be briefly very painful - consider remifentanil (0.25-1mcg/kg), alfentanil (5-7mcg/kg), or propofol bolus (30-50mg)

Barrett.Larson at 15:12, 1 June 2021

2021-06-01T15:12:20Z

← Older revision		Revision as of 08:12, 1 June 2021
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	* Coughing or valsalva should be avoided as much as possible		* Coughing or valsalva should be avoided as much as possible
	* If any cautery is used, the delivered FiO2 < 30%		* If any cautery is used, the delivered FiO2 < 30%
			* Oculocardiac reflex, caused by traction on extraocular muscles, can result in rapid decrease in heart rate and blood pressure.
			** Stop surgical manipulation, give atropine/glycopyrolate

	===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===		===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===

Barrett.Larson at 15:10, 1 June 2021

2021-06-01T15:10:25Z

← Older revision		Revision as of 08:10, 1 June 2021
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	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal
	\|Assess ~~patient's~~ risk		\|
			* Assess for GERD. Patient will need to lay flat and therefore at increased risk for aspiration
	\|-		\|-
	\|Hematologic		\|Hematologic
	\|Antiplatelet or anticoagulant drugs generally do not have to be stopped prior to cataract surgery given the low risk and minimal blood loss		\|
			* Antiplatelet or anticoagulant drugs generally do not have to be stopped prior to cataract surgery given the low risk and minimal blood loss
	\|-		\|-
	\|Renal		\|Renal
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	\|Endocrine		\|Endocrine
	\|		\|
			*
	\|-		\|-
	\|Other		\|Other
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	* Lidocaine-propofol-alfentanil mixtures<ref>{{Cite journal\|last=Fang\|first=Zhuang T.\|last2=Keyes\|first2=Mary A.\|date=2006-03-XX\|title=A novel mixture of propofol, alfentanil, and lidocaine for regional block with monitored anesthesia care in ophthalmic surgery\|url=https://linkinghub.elsevier.com/retrieve/pii/S0952818005003508\|journal=Journal of Clinical Anesthesia\|language=en\|volume=18\|issue=2\|pages=114–117\|doi=10.1016/j.jclinane.2005.08.007}}</ref> can be used for induction during application of retrobulbar or sub-tenon blocks by proceduralist		* Lidocaine-propofol-alfentanil mixtures<ref>{{Cite journal\|last=Fang\|first=Zhuang T.\|last2=Keyes\|first2=Mary A.\|date=2006-03-XX\|title=A novel mixture of propofol, alfentanil, and lidocaine for regional block with monitored anesthesia care in ophthalmic surgery\|url=https://linkinghub.elsevier.com/retrieve/pii/S0952818005003508\|journal=Journal of Clinical Anesthesia\|language=en\|volume=18\|issue=2\|pages=114–117\|doi=10.1016/j.jclinane.2005.08.007}}</ref> can be used for induction during application of retrobulbar or sub-tenon blocks by proceduralist
	* Benzodiazapenes (ex. midazolam) and opioids (ex. fentanyl) are commonly administered throughout the case as needed for patient comfort		* Benzodiazapenes (ex. midazolam) and opioids (ex. fentanyl) are commonly administered throughout the case as needed for patient comfort
			* Placement of retrobulbulbar or peribulbar blocks can be briefly very painful - consider remifentanil (0.25-1mcg/kg), alfentanil (5-7mcg/kg), or propofol bolus (30-50mg)
			** Be prepared to treat sudden decrease in blood pressure or apnea

	===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->===		===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->===
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	* Cataract surgeries are often very short in duration, with case duration ranging on average from 15 mins to 1 hour		* Cataract surgeries are often very short in duration, with case duration ranging on average from 15 mins to 1 hour
	* ~~Anesthesiologists~~ should ~~monitor~~		* Coughing or valsalva should be avoided as much as possible
			* If any cautery is used, the delivered FiO2 < 30%

	===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===		===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===