Current opinion in anaesthesiology · 2025
Ambulatory ophthalmic anesthesia: what is important.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Castello Roberto, Neth Jens
Аннотация
PURPOSE OF REVIEW: This review addresses aspects relevant to caregivers facing increased numbers of adult and elderly patients seeking ambulatory medical service for ophthalmic surgery.
RECENT FINDINGS: The 'Guidelines for the Provision of Ophthalmic Anaesthesia Services 2025' reinforce the importance of streamlined preoperative assessment with special consideration of frail elderly patients, removal of routine fasting for low-risk ophthalmic cases, and a structured interdisciplinary team-based approach to ensure readiness for complications. The 'Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients' stresses the importance of putative precipitating, but modifiable risk factors such as hemodynamic instability, inadequate analgesia, and depth of anesthesia. Remimazolam, a new short-acting benzodiazepine, has recently been approved for clinical use and has been investigated in endoscopic procedural sedation, among others. Studies in ophthalmic surgery patients are currently underway.
SUMMARY: With modern surgical techniques evolving rapidly beyond cataract extraction with lens replacement, less patients require overnight hospital facilities following their ophthalmic surgeries. Implementation of rational patient-adapted protocols facilitates the perioperative management of rising case-loads. Preoperative assessment includes identifying patients at risk of postoperative delirium and initiating nonpharmacological measures to minimize its incidence and duration. After the administration of retro-, peribulbar or sub-Tenon's anesthesia, anesthesiologists must be on the alert for adverse events such as retrobulbar hemorrhage, seizures, and brainstem anesthesia.
RECENT FINDINGS: The 'Guidelines for the Provision of Ophthalmic Anaesthesia Services 2025' reinforce the importance of streamlined preoperative assessment with special consideration of frail elderly patients, removal of routine fasting for low-risk ophthalmic cases, and a structured interdisciplinary team-based approach to ensure readiness for complications. The 'Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients' stresses the importance of putative precipitating, but modifiable risk factors such as hemodynamic instability, inadequate analgesia, and depth of anesthesia. Remimazolam, a new short-acting benzodiazepine, has recently been approved for clinical use and has been investigated in endoscopic procedural sedation, among others. Studies in ophthalmic surgery patients are currently underway.
SUMMARY: With modern surgical techniques evolving rapidly beyond cataract extraction with lens replacement, less patients require overnight hospital facilities following their ophthalmic surgeries. Implementation of rational patient-adapted protocols facilitates the perioperative management of rising case-loads. Preoperative assessment includes identifying patients at risk of postoperative delirium and initiating nonpharmacological measures to minimize its incidence and duration. After the administration of retro-, peribulbar or sub-Tenon's anesthesia, anesthesiologists must be on the alert for adverse events such as retrobulbar hemorrhage, seizures, and brainstem anesthesia.