The experience with the use of pterygo-palatine anesthesia for the osteoplastic interventions in pediatric ophthalmic surgery

The objective of the present study was to estimate the effectiveness and the adequacy of pterygo-palatine anesthesia for the plastic correction of the inferior orbital wall by means of double-access ophthalmic surgery. The study included the analysis of the anesthesiological support during 46 interventions for the treatment of the orbital injuries in the children aged 13-17 years. The results of the treatment were compared in three groups of the patients. Those in group 1 were given the nonsteroidal anti-inflammatory agent paracetamol and pterygo-palatine anesthesia (14 nacroses). The patients comprising control group 1 were given paracetamol and retrobulbar anesthesia (16 narcoses) whereas the patients of control group 2 were treated with the use of the natcotic analgetic fentanyl (16 narcoses). The following hemodynamic parameters were measured: the heart rate, systolic, diastolic, and mean arterial pressure, and ECG along with the concentrations of the inhaled anesthetics in the blood, the blood oxygenation level, and capnometry. It was shown that the application of regional anesthesia with a 0.75% naropin solution for the purpose of osteoplastic ophthalmic surgery on the children provides sufficiently deep narcosis in the absence of its undesirable effects on the hemodynamic parameters. It makes it possible to avoid the use of narcotic preparations and reduce the concentration of inhaled anesthetics. It is concluded that the proposed method improves the quality of the surgical treatment by reducing hemorrhage in the operative field; moreover, it significantly improves the postoperative period by virtue of long-term pain relief and rapid recovery of consciousness. Taken together, these effects accelerate rehabilitation of the patients.

pterygo-palatine anesthesia, retro-bulbar block, hemodynamics, injury to the obit