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Lokalanästhesie in der Ophthalmochirurgie

Local anesthesia in ophthalmic surgery

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Zusammenfassung

In den vergangenen Jahren hat sich das Spektrum der Anästhesietechniken in der Ophthalmochirurgie verändert. In der Kataraktchirurgie werden vermehrt topische Techniken angewendet. Folgende Lokalanästhesietechniken werden derzeit in der Ophthalmochirurgie eingesetzt: Retrobulbäranästhesie (RBA), Peribulbäranästhesie (PBA), Subtenonanästhesie (STA) sowie subkonjunktivale Anästhesie als injektive Verfahren, topische Applikationen als Tropf-, Gel- oder Sponge-Anästhesie sowie zusätzlich intrakamerale Anästhesie. Die entscheidenden Vorteile der injektiven Techniken RBA, PBA und STA sind die gute Analgesie und insbesondere die ausgeprägte Akinesie. Mit der Invasivität der einzelnen Techniken nehmen die Vis a tergo und die anästhesiologischen Komplikationen zu, umgekehrt steigt bei topischen Verfahren die Häufigkeit der Schmerzen bei fehlender Akinesie. Bei topischen Verfahren kann eine Verbesserung der Analgesie durch Unterstützung mit i.v.-Narkotika erreicht werden.

Abstract

In recent years anesthesia modalities have changed in ophthalmic surgery. A growing trend toward the use of topical anesthesia in cataract surgery is apparent. The present-day techniques used in ophthalmic surgery are retrobulbar anesthesia, peribulbar anesthesia, subtenon anesthesia, and subconjunctival anesthesia as injection techniques, topical anesthesia using drops, gel, or sponge, and intracameral anesthesia. Injectable anesthesia (RBA, PBA, STA) provides a higher level of analgesia and globe akinesia. With injection techniques the risks of vis a tergo and anesthetic complications increase; the level of analgesia after topical anesthesia could be improved by supplementation with i.v. narcotics.

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  1. Augen-Praxis-Klinik, Esslingen

    J. Weindler & M. Weindler

  2. Augenklinik und Poliklinik der Universitäten des Saarlandes Homburg/Saar

    K. W. Ruprecht

  3. Neckarstraße 71, 73732 , Esslingen

    J. Weindler

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  1. J. Weindler
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Weindler, J., Weindler, M. & Ruprecht, K.W. Lokalanästhesie in der Ophthalmochirurgie. Ophthalmologe 101, 847–865 (2004). https://doi.org/10.1007/s00347-004-1080-7

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