Perda visual no pós‐operatório de laminectomia cervical em pronação

Chandra, Kumar Naren; Kundan, Meghraj

doi:10.1016/j.bjan.2017.03.003

Cited by 3 publications

(5 citation statements)

References 15 publications

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“…3,[5][6][7] HBOT is a recently described treatment modality with encouraging results in case reports and small case series. 12 HBOT delivers 100% oxygen by a pressure greater than 1 atmosphere (atm), increasing plasma oxygen transportation and diffusion in order to keep the retina viable until circulation is restored via natural recanalization, which usually occurs within 72 hours. 12 The Undersea and Hyperbaric Medical Society has recommended that patients presenting for treatment within 24 hours after symptom onset should be considered for HBOT.…”

Section: Discussionmentioning

confidence: 99%

“…12 HBOT delivers 100% oxygen by a pressure greater than 1 atmosphere (atm), increasing plasma oxygen transportation and diffusion in order to keep the retina viable until circulation is restored via natural recanalization, which usually occurs within 72 hours. 12 The Undersea and Hyperbaric Medical Society has recommended that patients presenting for treatment within 24 hours after symptom onset should be considered for HBOT. 13 The combination of HBOT with anti-aggregation therapy may have had a synergistic effect contributing to the good outcome presented in this case.…”

Section: Discussionmentioning

confidence: 99%

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Hyperbaric oxygenation therapy treatment option in perioperative visual loss in spine surgery

et al. 2021

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<p class="abstract">Perioperative vision loss (POVL) is a catastrophic complication of spine surgery and several risk factors are identified. As spine fusion surgery is rising in number, POVL incidence is increasing. Preventive strategies can decrease the risk of this complication. Prognosis depends on the level of occlusion and how quickly oxygen supply can be restored to retina. We present a 65-year-old female patient with multiple cardiovascular risk factors that who underwent lumbar fusion. Upon waking up from anesthesia, the patient reported total loss of vision in her left eye. An occlusion of the central retinal artery due to a probable embolic cause was diagnosed and the patient promptly started treatment with anti-aggregation therapy and hyperbaric oxygen therapy (HBOT) with good results. The combination of HBOT with anti-aggregation therapy may have had a synergistic effect contributing to the good outcome presented in this case and may be a good option for the treatment of this patients. </p>

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygenation therapy treatment option in perioperative visual loss in spine surgery

et al. 2021

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“…Pode-se apresentar como uni ou bilateral, sendo encontrada em 0,0008 a 0,003% dos procedimentos cirúrgicos realizados na posição prona. Normalmente a perda é precoce no pós-operatório, sendo associada a falta de percepção luminosa, oftalmoplegia e ptose (4,5,(14)(15)(16)(17)(18)(19) .…”

Section: Perda Visualunclassified

“…Vários elementos podem ocasionar a perda visual, incluindo neuropatia óptica isquêmica, oclusão da artéria central da retina, síndrome do compartimento orbital isquêmico e infarto cerebral occipital, sendo, por sua vez, consequentes à redução da pressão de perfusão, anemia, hemodiluição e hemorragia. Entre os fatores de risco, destacam-se o gênero masculino, obesidade, diabetes mellitus, coagulopatias, desordens neurológicas prévias e idade igual ou superior a 65 anos (4)(5)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) .…”

Section: Perda Visualunclassified

“…A pressão de perfusão ocular é determinada pela diferença entre a pressão arterial média (PAM) e a pressão intraocular (PIO), portanto, tanto uma redução da pressão arterial média quanto aumento da PIO vão reduzir a perfusão e podem, por conseguinte, gerar perda visual (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) .…”

Section: Variações Da Pressão Intraocularunclassified

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Complicações associadas à posição prona na neurocirurgia: uma revisão sistemática / Complications associated with prone positioning in neurosurgery: a systematic review

Brito¹,

Lacerda²,

Castro³

et al. 2021

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introdução: A escolha da posição do paciente na neurocirurgia é um processo que se baseia no sítio de intervenção e na prevenção de complicações, considerando-se a máximasegurança para o paciente. O posicionamento em prona está ligado a complicações transitórias e permanentes pouco discutidas. Método: Pesquisou-se os termos “pronação”,“decúbito ventral”, “prona”, complicações”, “intercorrências” e variações utilizado os operadores booleanos OR e AND, em diferentes estratégias. Resultados: Selecionou-se49 artigos, que relataram complicações hemodinâmicas, visuais, neurológicas, musculares e venosas, de caráter transitório ou permanente. As complicações estão associadastanto a aspectos da cirurgia, como movimentação adotada durante o procedimento, hipovolemia, hemorragia e tempo cirúrgico, quanto a comorbidades dos pacientes, como obesidade, hipertensão arterial e diabetes mellitus. Discussão: A posição prona exige observação dos fatores de risco, para escolha de posicionamentos alternativos, e, caso adotada, a monitorização do paciente, a fim de reduzir complicações. Conclusão: Nenhum posicionamento está destituído de riscos, sendo necessário conhecer as complicações a fim de se melhor avaliar a escolha do posicionamento. Palavras chave: Decúbito ventral, Neurocirurgia, Laminectomia, Cuidados pós-operatórios ABSTRACTIntroduction: The choice of patient positioning in neurosurgery is a process that is based on the intervention site and prevention of complications, in order to ensure maximumpatient safety. The prone position requires patient monitoring to reduce complications. Alternative positions must be considered if there are patient risk factors Method: Theterms “pronation”, “prone position”, “prone”, “complications” and variations were used with the boolean operators OR and AND in different strategies. Results: Forty-nine articles were selected that reported transient or permanent hemodynamic, visual, neurological, muscular and venous complications. Complications are associated with surgical aspects, such as movements adopted during the procedure, hypovolemia, hemorrhage, surgical time, and patients’ comorbidities, such as obesity, arterial hypertension, and diabetes mellitus. Discussion: The prone position requires patient monitoring to reduce complications. Alternative positions must be considered if there are patient risk factors. Conclusion: No positioning is without risks, and it is necessary to know the complications to better assess the positioning choice.Keywords: Prone position, Neurosurgery, Laminectomy, Postoperative care

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Darkening vistas: Central retinal artery occlusion post-Arnold Chiari 1 surgery in prone position

Shrinkhal,

Keelara,

Suman

et al. 2024

The Pan-American Journal of Ophthalmology

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Post-operative vision loss (POVL) following spine surgery in the prone position is rare but has been documented. Various pathophysiological mechanisms have been proposed as potential causes, with associated risk factors identified. This article documents an interesting case of a patient who presented with Chiari 1 malformation and developed central retinal artery occlusion (CRAO) postoperatively. We present the case of a 27-year-old male who underwent foramen magnum decompression with C1–C2 fusion for Chiari I malformation, and experienced sudden vision loss in his left eye postoperatively, attributed to CRAO. Despite stable vital signs and minimal blood loss during surgery, the patient developed CRAO after awakening from anesthesia. Prompt treatment was initiated, resulting in partial recovery of vision. However, challenges in treating CRAO persisted, highlighting the importance of meticulous patient positioning during prone surgeries to prevent such complications. Early detection and intervention are crucial for the potential reversibility of visual loss.

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Perda visual no pós‐operatório de laminectomia cervical em pronação

Cited by 3 publications

References 15 publications

Hyperbaric oxygenation therapy treatment option in perioperative visual loss in spine surgery

Hyperbaric oxygenation therapy treatment option in perioperative visual loss in spine surgery

Complicações associadas à posição prona na neurocirurgia: uma revisão sistemática / Complications associated with prone positioning in neurosurgery: a systematic review

Darkening vistas: Central retinal artery occlusion post-Arnold Chiari 1 surgery in prone position

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