Journal of Clinical Monitoring and Computing

, Volume 32, Issue 2, pp 351–358 | Cite as

Short term general anesthesia for retro-bulbar block in ophthalmic surgery generates no significant hypercapnia

  • Werner Baulig
  • Monica Weber
  • Beatrice Beck-Schimmer
  • Oliver M. Theusinger
  • Peter Biro
Original Research
First Online:
Received:
Accepted:
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Abstract

To assess the impact of short time hypnosis for retro-bulbar anesthesia on ventilation in patients undergoing ophthalmic surgery of the anterior eye chamber. In all patients, a combined continuous transcutaneous carbon dioxide tension (PtcCO2) and partial oxygen saturation (SpO2) measurement was applied in addition to routine monitoring. To enable unconscious application of retro-bulbar anesthesia, intravenous thiopental was given in one to multiple bolus doses. Transient breathing support included chin lift, Esmarch maneuver and manual hand-bag ventilation via face mask. Main endpoints were apnea time, recovery time according to the Richmond Agitation Sedation Scale, as well as SpO2 and PtcCO2 readings at predefined time points. Fifty-two patients with a mean age of 68 ± 13 years were included. Average thiopental dose was 2.7 ± 0.6 mg/kg. In seven (13.5%) patients repeated doses of thiopental were necessary to a total of 3.3 ± 1.1 mg/kg. Except one patient, no severe, significant or clinical relevant hypercapnia or desaturation periods were observed, and the occurring elevation of PtcCO2 values did not correlate with the application of repeated doses of thiopental or the need for the Esmarch maneuver. Higher PtcCO2 values were associated with the presence of hypertension and smoking. Apnea (p < 0.001) and recovery (p = 0.003) time were significantly prolonged in the patients needing the Esmarch maneuver. Short term anesthesia with thiopental in ophthalmic surgery is associated with a mild but not clinically relevant hypercapnia.

Keywords

PtcCO2 monitoring Thiopental anesthesia Ophthalmic surgery 
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Notes

Author contributions

Author Werner Baulig has received a speaker honorarium from the SenTec AG, Therwil, Switzerland. Oliver M. Theusinger has received honoraria or travel support for consulting or lecturing from the following companies: CSL Behring Schweiz, Zurich, Switzerland, Vifor SA, Villars-sur-Glâne, Switzerland, Roche Pharma (Schweiz) AG, Reinach, Switzerland, Pentapharm AG, München, Germany, TEM International GmbH, München, Germany, Boehringer Ingelheim (Schweiz).

Funding

This work was supported by departmental resources and by the SenTec AG Therwil, Switzerland which provided the device and the sensors to conduct the study.

Compliance with ethical standards

Conflict of interest

Monica Weber, Beatrice Beck-Schimmer and Peter Biro declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This research was approved by the Cantonal Ethics Committee (KEK-ZH 2010 –0222).

Informed consent

Informed consent was obtained from all individual participants included in the study. All participants included in this study were informed in writing and verbally about the study and any related complications and have given their written consent to participate.

Research involving human and animal participants

This is a research involving human participants.

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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  • Werner Baulig
    • 1
  • Monica Weber
    • 2
  • Beatrice Beck-Schimmer
    • 2
  • Oliver M. Theusinger
    • 2
  • Peter Biro
    • 2
  1. 1.Department of Anesthesiology and Intensive Care MedicineHirslanden Klinik im ParkZurichSwitzerland
  2. 2.Institute of AnesthesiologyUniversity Hospital ZurichZurichSwitzerland

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