Adjustable Strabismus Surgery under Intravenous Anesthesia with Propofol and Fentanyl

In Tae Kim; Sang Hyun Cho; Mi Ra Park; Soo Chul Park

doi:10.3341/jkos.2007.48.11.1522

Journal List > J Korean Ophthalmol Soc > v.48(11) > 1007965

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Cho, Park, and Park: Adjustable Strabismus Surgery under Intravenous Anesthesia with Propofol and Fentanyl

Original Article

J Korean Ophthalmol Soc 2007;48(11):1522-1526.

Published online: 28 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.11.1522

Adjustable Strabismus Surgery under Intravenous Anesthesia with Propofol and Fentanyl

In Tae Kim, M.D.¹, Sang Hyun Cho, M.D.¹, Mi Ra Park, M.D.¹, Soo Chul Park, M.D.²

¹Department of Ophthalmology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

²Saevit Eye Hospital, Gyeonggi, Korea

Address reprint requests to Soo Chul Park, M.D., Saevit Eye Hospital, #1334-3 Baekseok-dong, Ilsandong-gu, Goyang-si, Gyeonggi 411-360, Korea, Tel: 82-31-900-7769, Fax: 82-31-900-7799, E-mail: scpark@enpal.com

Received 8 December 2006 Accepted 11 July 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical usefulness of intravenous propofol and fentanyl anesthesia during adjustable strabismus surgery, to investigate the effectiveness and safety of adjustable strabismus surgery, and assess the degree of patient satisfaction.

Methods

Patients over 15 years of age who underwent strabismus surgery using propofol and fentanyl sedation from January 2003 to December 2004 were included in this study. At the beginning of the operation, the patients received an intravenous bolus of fentanyl 1 to 1.5 mg/kg. Propofol was injected into a vein continuously during the operation to keep the blood concentration within 1.2-1.5 ug/mL. Intraoperative adjustment was then made. We evaluated, via questionnaire, patient satisfaction with the operation and the adjustment.

Results

In all 44 patients, the adjustment was completed successfully. The rate of intraoperative side effects was low (11.4%). The satisfaction degree regarding the anesthesia was very high (95.5%), and the success rate at the three-month postoperative visit was 88.6%.

Conclusions

Intravenous anesthesia using propofol combined with fentanyl provides a sufficient level of sedation and rapid awakening that enables a surgeon to perform adjustable strabismus surgery conveniently. It also allows the patient to feel comfortable and safe throughout the surgery.

Keywords: Intraoperative adjustable surgery, Propofol

References

1. Yang YS, Lee SH, Kim SD, Kim JD. Tolerance of patients and Postoperative results: Strabismus surgery under topical anesthesia. J Korean Ophthalmol Soc. 1997; 38:194–8.

2. Garu RD. Topiccal Anesthesia for strabismus surgery. J Pediatr Ophthalmol strabismus. 1989; 26:86–90.

3. Kraft SP, Jacobson ME. Techniques of adjustable suture strabismus surgery. Ophthalmic Surgery. 1990; 21:633–40.

4. Jamposky AJ. Strabismus reoperation techniques. Transactions. Section on Ophthalmology. American Academy of Ophthalmology and Otolaryngology. 1975; 79:704–17.

5. Roh YB, Park WS. Adjustable Suture Technique in Pediatric Strabismus with Ketamine Anesthesia. J Korean Ophthalmol Soc. 2001; 41:106–10.

6. Miller RD. Anesthesia. 5th ed.1. Philadelphia: Churchill-Livingstone;2000. p. 1452–69.

7. Ohmi G, Hosohata J, Okada AA, et al. Strabismus surgery using the intraoperative adjustable suture method under anesthesia with propofol. Jpn J Ophthalmol. 1999; 43:522–5.

8. Cogen MS, Guthrie ME, Vinik HR. The immediate postoperative adjustment of sutures in strabismus surgery with comaintenance of anesthesia using propofol and midazolam. J AAPOS. 2002; 6:241–5.

9. The Korean society of Anesthesiolgy. Anesthesiology. 3rd ed.1. Seoul: Yeo Mun Gak;1987. p. 85–7.

10. Cho CK, Hong YJ. Total Intravenous Anesthesia with Propofol and Fentanyl. Korean J Anesthesiol. 1993; 26:465–77.

11. Cho YJ, Song SY, Lim GJ. Case Report of Severe Bradycardia and Mobitz Type I A-V Block after Anesthetic Induction with a Fentanyl-Propofol Sequence. Korean J Anesthesiol. 1994; 27:1470–3.

12. Kim SB, Lee IO, Kong MH, et al. Postoperative Pain Evaluation Facial Rating Scale Compared with Visual Analogue Scale. Korean J Anesthesiol. 2000; 39:696–9.

13. Song SO, Kim SY, Lee SY. Correlations between Numerical Rating Scale and Visual Analog Scale Pain Scores in the Assessment of postoperative Pain. Korean J Anesthesiol. 2003; 45:238–43.

14. Chin HS, Kim HS, Lee JB, Han SH. The Effect of Intraoperative Adjustment Strabismus Surgery Under Topical Anesthesia. J Korean Ophthalmol Soc. 1996; 37:1915–9.

15. Kim SJ, Park YJ. Topical Anesthesia in Pediatric Strabismus Surgery. J Korean ophthalmol Soc. 1998; 39:400–5.

16. Jin YH, Kwak CH. Intraoperative Adjustment with Topical Anesthetics in Strabismus Surgery. J Korean Ophthalmol Soc. 1992; 33:258–61.

Figure 1.

Target controlled infusion pump.

Figure 2.

The visual analogue scale representing patients’ discomfort during the surgery.

Table 1.

Types of strabismus surgery included in this study

Diagnosis	Patients (%)
Exotropia	14 (32%)
Esotropia	11 (25%)
Sensory strabismus	10 (23%)
Hypertropia	1 (2%)
Paralytic strabismus	6 (14%)
Duane's retraction syndrome	1 (2%)
Thyroid opthalmopathy	1 (2%)
Total	44

TOOLS

Similar articles