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Kim, Nam, Lee, and Lee: Changes in Angular Deviations under General Anesthesia for Strabismus Surgery with Objective Anesthetic Depth Control
Original Article

Journal of the Korean Ophthalmological Society 2018; 59(9): 848-853.

Published online: 17 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.9.848

Changes in Angular Deviations under General Anesthesia for Strabismus Surgery with Objective Anesthetic Depth Control

Chang Zoo Kim, MD1, Ki Yup Nam, MD, PhD1, Seung Uk Lee, MD, PhD1, Sang Joon Lee, MD, PhD1, 2

1Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea.

2Instutute for Medicine, Kosin University College of Medicine, Busan, Korea.

Address reprint requests to Sang Joon Lee, MD, PhD. Department of Ophthalmology, Kosin University Gospel Hospital, #262 Gamcheon-ro, Seo-gu, Busan 49267, Korea. Tel: 82-51-990-6228, Fax: 82-51-990-3026, hhiatus@gmail.com

Received 17 May 2018       Revised 26 June 2018       Accepted 22 August 2018

©2018 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

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

Changes in angular deviation before and after general anesthesia and strabismus surgery were examined.

Methods

Twenty patients with intermittent exotropia who were operated on by the same surgeon from January 2014 to October 2017 were included. The basic angle of deviation (preoperative angle of deviation, PreAn) was measured at an outpatient clinic. While lying on a surgical bed under general anesthesia, the bispectral index was referenced, and it was confirmed that there was a sufficient degree of sedation. Photographs were then taken at a height of 40 cm (angle of deviation under general anesthesia, PostAn); while still under general anesthesia, the same procedure was followed immediately after the end of surgery. At 6 months after surgery, the angle of deviation was measured.

Results

There were 10 males and 10 females, and the mean age was 7.31 ± 3.59 years. The preoperative angle of deviation was 30.0 ± 13.87 prism diopters (PD) at far fixation; under general anesthesia, 26.46 ± 5.39 PD. There was a significantly positive correlation between the PreAn and angle of deviation under general anesthesia (PostAn - PreAn = −7.67 × PreAn + 19.57; R2 = 0.872; p < 0.00). The angle of deviation changes between pre- and post-anesthesia (PostAn-PreAn) and at the end point of surgery (OP end) and at 6 months after surgery (6mon) also showed a significantly positive correlation (6mon-OP end = 0.317 × [PostAn - PreAn] + 13.098; R2 = 0.334; p = 0.01).

Conclusions

There was a significant positive correlation between the measured angle of deviation pre- and post-anesthesia. We could estimate the degree of change between the angle of deviation immediately after surgery and the stable angle according to the degree of deviation before and after general anesthesia.

Keywords: Angle of deviation, Exotropia, General anesthesia

Figures and Tables

Figure 1

Schematic illustration showing the angle of deviation in the surgical plane of general anesthesia. The changed angle is calculated by this formula (from Ku et al.4).

jkos-59-848-g001
Figure 2

Relationship between the PreAn and PostAn-PreAn, expressed as a linear regression with simple scatter dots and fit line. PostAN-PreAn = −7.67 × PreAn + 19.57 (R2 = 0.872, p<0.00). PreAn = preoperative angle of deviation; PostAn = angle of deviation under general anesthesia.

jkos-59-848-g002
Figure 3

Relationship between the PostAn-PreAn and 6mon-OP end, expressed as a linear regression with simple scatter dots and fit line. 6mon-OP end = 0.317 × (PostAn-PreAn) + 13.098 (R2 = 0.334, p = 0.01). PreAn = preoperative angle of deviation; PostAn = angle of deviation under general anesthesia; 6mon = angle of deviation at 6th month after strabismus operation; OP end = angle of deviation before waking from general anesthesia after strabismus surgery.

jkos-59-848-g003
Table 1

Baseline characteristics

jkos-59-848-i001

Values are presented as mean ± SD unless otherwise indicated.

PD = prism diopter.

Notes

This study was supported by a grant from University Research Park Project of Busan National University funded by Busan Institute of S&T Evaluation and Planning.

Conflicts of Interest The authors have no conflicts to disclose.

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