Local anesthesia and anxiolytic techniques for oculoplastic surgery

Ing, Edsel; Philteos, Justine; Sholohov, Galina; Kim, David Ta; Nijhawan, Navdeep; Mark, Patrick; Gilbert, J. Raymond

doi:10.2147/opth.s188790

Cited by 15 publications

(12 citation statements)

References 65 publications

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“…background music) and tactile techniques (e.g. stress balls) during all the perioperative period 16. • Supplemental Oxygen:o SpO 2 94% -98% acceptable for most patients, if type II respiratory insufficiency aim at 88% -92%.…”

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confidence: 99%

The Role of Locoregional Anesthesia in the Covid-19 Pandemic

et al. 2020

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Coronavirus disease 2019 (COVID-19) refers to the respiratory tract infection caused by the newly emergent coronavirus SARS-CoV-2. The present pandemic, declared on the 11th of March 2020, was first recognized in Wuhan city, and rapidly spread throughout China and other countries, including Portugal. Regional anesthesia should be considered whenever surgery is planned for a patient with suspected or confirmed COVID-19, as it minimizes not only airway management, the intervention with the highest risk of aerosolization, but also potential personnel contamination and patient recovery time, while maximizing operation room efficiency. Anesthesia techniques should be aimed at preventing airway manipulation such as endotracheal intubation, which is associated with a higher risk of pulmonary complications in infected patients. These recommendations are structured in pre-, intra-, and post-operative management in suspected or confirmed infected patients with SARS-CoV-2, based in local hospital infection committee recommendations and the most recent literature available regarding regional anaesthesia. They are aimed at anesthesiology personnel, with the main goals being both teamand patient safety. The SARS-CoV-2 virus will be not the last novel virus to trigger global pandemics, so having a well-structured regional anesthesia plan to manage this kind of cases will ensure the best outcome possible to both patients and the perioperative team.

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confidence: 99%

The Role of Locoregional Anesthesia in the Covid-19 Pandemic

et al. 2020

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“…The anxiolytic effect of visual, auditory and tactile distraction techniques was constantly performed by operators and technicians, as already demonstrated in other surgical fields [ 32 ], which is reinforced by the use of nitrous oxide inhalation which presents both an anxiolytic and analgesic effect [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Bipolar Radiofrequency Ablation of Painful Spinal Bone Metastases Performed under Local Anesthesia: Feasibility Regarding Patient’s Experience and Pain Outcome

et al. 2021

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Background and objectives: To assess the pain relief of bipolar RFA combined or not with vertebroplasty in patients with painful vertebral metastases and to evaluate the feasibility and tolerance of the RFA procedure performed under local anesthesia. Materials and Methods: 25 patients (18 men, 7 women, mean age: 60.X y.o) with refractory painful vertebral metastasis were consecutively included between 2012 and 2019. A total of 29 radiofrequency ablation (RFA) procedures were performed under CT guidance, local anesthesia and nitrous oxide inhalation, including 16 procedures combined with vertebroplasty for bone consolidation purposes. Pain efficacy was clinically evaluated using the visual analogue scale (VAS) at day 1, 1 month, 3 months, 6 months and 12 months, and the tolerance of the procedure was evaluated. Results: Procedure tolerance was graded as either not painful or tolerable in 97% of cases. Follow-up postprocedure mean VAS score decrease was 74% at day 1: 6.6 (p < 0.001), 79% at 1 month: 6.6 (p < 0.001), 79% at 3 months: 6.5 (p < 0.001), 77% at 6 months, and 79% at 12 months: 6.6 (p < 0.001). Conclusions: Bipolar RFA, with or without combined vertebroplasty, appears to be an effective and reliable technique for the treatment of refractory vertebral metastases in patients in the palliative care setting. It is a feasible procedure under local anesthesia which is well tolerated by patients therefore allowing to broaden the indications of such procedures. Field of study: interventional radiology.

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“…6 The ION blocks are widely used for regional anesthesia in dermatologic excisions of lesions, lower eyelid reconstruction, scar revisions, and facial repair. 4,11,16,29 They may also be used for chronic facial pain control and diagnosing postherpetic neuralgia. 11,29 Filler injections and blocks are done without preoperative imaging or intraoperative visualization.…”

Section: Discussionmentioning

confidence: 99%

“…T he infraorbital nerve (ION) is vulnerable as it exits the infraorbital foramen (IOF) in a wide range of orbital and midface procedures: orbital decompression surgery, midface reconstructive surgery, regional nerve blocks, and deep filler injections. [1][2][3][4] In some procedures, such as nerve blocks and deep filler injections, there is minimal visualization, or use of preoperative imaging, in identifying the underlying neurovascular structures and a greater reliance on neighboring anatomical landmarks. 5,6 Damage to the ION may result in paresthesia, hyperaesthesia, or neuralgiform pain of the midface region, inferior eyelids, nasal sidewall, and superior aspect of the lips.…”

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confidence: 99%

Positional Variation of the Infraorbital Foramen in Caucasians and Black Africans from Britain: Surgical Relevance and Comparison to the Existing Literature

Aseem

Scantling‐Birch

Naveed

et al. 2020

Journal of Craniofacial Surgery

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Background: Midface augmentation and orbital surgery carry an inherent risk of injury to the infraorbital vascular bundle, especially the infraorbital nerve where it exits the infraorbital foramen (IOF). This can result in significant morbidity for the patient, including paresthesia and neuralgia. Studies report significant heterogeneity in IOF position according to gender, ethnicity, and laterality. A knowledge of the relationship of the IOF to regional soft tissue, bony landmarks, and its variation among ethnicities is likely to reduce iatrogenic injuries. Methods: A single-center retrospective computed tomography (CT)-based study was conducted. Twenty Caucasians and 20 Black Africans patients were selected from an existing radiologic database at Moorfields Eye Hospital, London, UK. DICOM image viewing software (Syngo, Siemens Healthineers) was used to record the position of the IOF using standardized sagittal and axial views. Results: There was a statistically significant difference in the horizontal position of the IOF in the 2 races (P ¼ 0.00). The combined measurements were used to derive a rectangular zone of variability measuring 14.30 mm by 10.60 mm. This zone was found to lie 3.50 mm below the infraorbital rim, 7.10 mm medial to the piriform aperture, and 11.60 mm from the lateral orbital rim. Conclusion: A sound knowledge of key facial landmarks is necessitated when performing midface augmentation and orbital surgery. An anatomical safe zone depicting the variation of the IOF will help reduce iatrogenic injury to the infraorbital nerve and prevent patient morbidity.

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Local anesthesia and anxiolytic techniques for oculoplastic surgery

Cited by 15 publications

References 65 publications

The Role of Locoregional Anesthesia in the Covid-19 Pandemic

The Role of Locoregional Anesthesia in the Covid-19 Pandemic

Bipolar Radiofrequency Ablation of Painful Spinal Bone Metastases Performed under Local Anesthesia: Feasibility Regarding Patient’s Experience and Pain Outcome

Positional Variation of the Infraorbital Foramen in Caucasians and Black Africans from Britain: Surgical Relevance and Comparison to the Existing Literature

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