Anesthesia for Pediatric Ophthalmologic Surgeries

Abstract

Abstract Commonly performed pediatric ophthalmologic procedures performed under anesthesia include eye examination for tonometry, fundoscopy, and assessment of visual evoked potentials, cryotherapy or laser therapy for retinopathy of prematurity or retinoblastoma, strabismus repair, lens extraction in cataracts, and enucleation, which are predominantly performed in the ambulatory setting. However, special considerations are needed in premature infants with congenital disorders associated with pathology of the eye. An understanding of oculocardiac reflex (OCR) and postoperative nausea and vomiting (PONV) is more pertinent to pediatric ophthalmic surgeries. Differing from adult ophthalmic surgeries, use of regional blocks are not commonly used. Therefore, perioperative pain management needs to be considered, especially with more invasive procedures. This chapter describes the anatomy and physiology of the eye and the perioperative anesthetic management of commonly performed ophthalmic procedures in the pediatric population.