Systemische und okuläre Begleiterkrankungen bei Katarakt-Patienten

Spraul, Christoph W.; Jakobczyk-Zmija, Martha J.; Tobis, M.; Lang, Gerhard K.

doi:10.1055/s-2008-1034742

Cited by 6 publications

(6 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The endocrine stress and the increase in mean arterial pressure are of special interest because cataract patients have a higher prevalence of systemic co-morbidity (hypertension, coronary heart disease) compared with the general population of the same age [9, 10, 11]. Cardiovascular complications are among the major causes of perioperative morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Piritramide for Analgesia and Sedation during Peribulbar Nerve Block for Cataract Surgery

Reinhardt

Burkhardt²,

Nestler³

et al. 2002

Ophthalmologica

View full text Add to dashboard Cite

Purpose: To investigate the effects of pre-block analgesia and sedation using piritramide on haemodynamic stability, endocrine stress response and patients’ pain perception. Methods: In a randomized, single-blinded, placebo-controlled study, 60 patients having cataract surgery with peribulbar block were randomly assigned into two groups: group A (n = 30) received 0.05 mg/kg piritramide (Dipidolor^®) intravenously; group B received normal saline intravenously prior to peribulbar block. Mean arterial pressure, heart rate, respiratory rate and pulse oximetry were recorded perioperatively. Pain from peribulbar block was assessed using a verbal analogue scale. Urinary excretion of vanillylmandelic acid was measured to assess the endocrine stress response. Using a questionnaire, patients assessed their anxiety and back pain before and during surgery. Results: Mean arterial pressure remained near baseline in group A. In group B, a significant increase in mean arterial pressure after peribulbar block was found (p < 0.001). In addition, a significant increase in urinary excretion of vanillylmandelic acid was found in group B (p = 0.013). Pain scores (p < 0.001), anxiety before nerve block (p = 0.02) and during surgery (p < 0.001) and back pain (p = 0.003) were significantly lower in group A. Conclusion: The presented study suggests that using piritramide for analgesia and sedation prior to peribulbar block produces haemodynamic stability and reduces pain perception and endocrine stress response.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In addition, pain and anxiety are followed by endocrine stress response, leading to cardiovascular reactions. This causes problems since the patients are usually elderly and often display concomitant systemic diseases [9, 10, 11]. Cardiovascular complications are therefore among the major causes of perioperative morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Use of Piritramide for Analgesia and Sedation during Peribulbar Nerve Block for Cataract Surgery

Reinhardt

Burkhardt²,

Nestler³

et al. 2002

Ophthalmologica

View full text Add to dashboard Cite

show abstract

“…Die Patienten gehören aufgrund ihres Alters und Nebenerkrankungen häufig zu den ASA-Risikogruppen III und IV. Insbesondere Patienten mit Begleiterkrankungen werden universitären Zentren zugewiesen, was dort eine negative Selektionierung bewirkt [109]. Die operativen Maûnahmen am Auge und die eingesetzten Ophthalmika können gravierende systemische Effekte, u. a. am kardiovaskulären System auslösen.…”

Section: Introductionunclassified

“…Eye´intraocular pressure´oculocardiac reflex´orbital regional anaesthesia´retrobulbar block´standby´cataract´strabism´penetrating eye injury´intraocular surgery´anaesthesia´topical anaesthesia auch an 90 ± 100-Jährigen keine Seltenheit mehr dar. In einer an einem universitären Zentrum durchgeführten Studie über Begleiterkrankungen bei Kataraktpatienten wiesen bei einem mittleren Alter von 70,4 Jahren, 32 % der Patienten systemische Begleiterkrankungen und 61 % systemische und okuläre Begleiterkrankungen kombiniert auf [109]. Lediglich 2 % der Patienten zeigten keine Begleiterkrankungen [109].…”

Section: Introductionunclassified

“…In einer an einem universitären Zentrum durchgeführten Studie über Begleiterkrankungen bei Kataraktpatienten wiesen bei einem mittleren Alter von 70,4 Jahren, 32 % der Patienten systemische Begleiterkrankungen und 61 % systemische und okuläre Begleiterkrankungen kombiniert auf [109]. Lediglich 2 % der Patienten zeigten keine Begleiterkrankungen [109]. Besonders die Inzidenz von Herz-Kreislauf-Erkrankungen (Herzinsuffizienz, Hypertonie, koronare Herzerkrankung) ist deutlich höher verglichen mit dem Profil der gleichen Altersgruppe in der Gesamtbevölkerung, die Prävalenz für Diabetes mellitus lag mit 27 % sogar ca.…”

Section: Introductionunclassified

See 1 more Smart Citation

Was gibt es Neues in der Ophthalmoanästhesie?

Weigt

Spraul²,

Weiß³

2003

Klin Monatsbl Augenheilkd

View full text Add to dashboard Cite

In the past few years, there have been many changes in ophthalmic anaesthesia. Application of drugs in general anaesthesia with excellent controllability enhances patient safety and allows a more efficient OR-management. Regional anaesthesia is gaining widespread use for ophthalmic surgery, especially topical anaesthesia for cataract surgery. Patients for ophthalmic surgery concomitantly often display high age and a high level of co-morbidity and, therefore, belong to the anaesthesiological risk groups ASA III-IV. Life-threatening adverse events including cardiovascular depression are associated with general and regional anaesthesia. Intervention by anaesthesiologists is frequently required for treatment of hypertension or dysrhythmias, and sedation. Thus, monitored anaesthesia care ("standby") is justified. Drugs applied for regional and general anaesthesia may change intraocular pressure. There are a lot of publications about the impact of anaesthesia on intraocular pressure (IOD), however, few on the effects of anaesthesia on pulsatile ocular blood flow. it has to be kept in mind that the effects of anaesthesia on intra-ocular pressure and pulsatile ocular blood flow may diverge. To avoid an increase of the IOD, especially during anaesthesia induction, drugs, such as succinylcholin, rocuronium and opiates, in particular remifentanil, can be applied. In addition, the use of the laryngeal mask may be advantageous compared to general anaesthesia associated with laryngoscopic tracheal intubation. The management of patients treated with anticoagulants and antiplatelet agents, has to be taken on the balance of risks. There are risks not only in continuing therapy, but also in discontinuing it perioperatively. Postoperative nausea and vomiting (PONV) remains a distressing and common problem after strabismus repair in particular in children. The incidence of PONV depends on the type of ophthalmic surgery and drugs applied. To reduce PONV in ophthalmic surgery, application of long-lasting opiates should be avoided, and non-opiate analgesics and, depending on the kind of operation, antiemetic prophylactics are recommended.

show abstract

Beeinflussende Faktoren für die Entscheidung zur Kataraktoperation — eine Pilotstudie

Richter-Mueksch

Zehetmayer

Radner

et al. 2002

Spektrum Augenheilkd

View full text Add to dashboard Cite

Zusammenfassung. Ziel dieser Pilotstudie war es herauszufinden, ob Alter, Geschlecht, systemische Erkrankung and prdoperativer Visus Einfluss auf die Entscheidung der Patienten zur Kataraktoperation haben.Methode: Dies ist eine retrospektive Studie fiber 100 konsekutive, am ersten Auge operierte Patienten mit altersbedingter Katarakt. Es wurden Alter, Geschlecht, praoperativer Visus beider Augen, okulare and systemische Erkrankungen and Zeit der praoperativen Visusverschlechterung erfasst. Patienten mit okularen Zweiterkrankungen wurden exkludiert.Resultate: Das mittlere Alter der Frauen dieser Studie betrug 75,2 Jahre, das der Manner 71,3 Jahre. Der preoperative Visus der Frauen war 0,32, jener der Manner 0,23. Die Zeit der praoperativen Visusverschlechterung betrug 8,1 beziehungsweise 13,2 Monate. Alle diese Differenzen waren statistisch signifikant (p < 0,05). Es konnten keine statistisch signifikanten Unterschiede zwischen Frauen and Mannern, das bessere Auge betreffend, gefunden werden. Weder das Vorhandensein oder die Art einer systemischen Erkrankung noch das Alter beeinflusste den praoperativen Visus oder die Zeit der praoperativen Visusverschlechterung.Diskussion: Manner in unserer Studie unterzogen sich erst nach einer langeren Zeit der praoperativen Visusverschlechterung and einem schlechteren Visus einer Kataraktoperation. Es benotigt denmach wesentlich mehr offentliche Information fiber die Kataraktoperation, um diese Zeit moglichst minimal zu halten.Schlusselworter: Katarakt, Kataraktoperation, Geschlecht, systemische Erkrankung.Influencing factors for the decision to cataract operation -a pilot study Summary. Purpose: The aim of this pilot study was to determine the influence of age, gender, systemic disease and visual acuity for the patients' decision to undergo cataract operation.Methods: This is a retrospective study of 100 consecutive patients with age-related cataract operated on the first eye. Age, gender, preoperative visual acuity of both eyes, duration of preoperative visual deterioration as well as ocular and systemic comorbidity were recorded. Patients with ocular comorbidity were excluded.Results: The mean age of men and women in the present study was 75.2 years and 71.3 years, respectively. The preoperative visual acuity of women was 0.32 and that of men, 0.23. The duration of preoperative visual deterioration was 8.1 and 13.2 months, respectively. All differences were statistically significant (p < 0.05). The visual acuity of the better eye was not significantly different between men and women. Neither the presence nor the kind of systemic disease nor the age of the patients influenced preoperative visual acuity and the duration of preoperative visual deterioration.Conclusions/Discussion: We found that men undergo cataract surgery after a longer duration of visual deterioration and with a worse visual acuity. More public information about cataract surgery is required in order to keep visual deterioration secondary to cataract as low as possible.

show abstract

Systemische und okuläre Begleiterkrankungen bei Katarakt-Patienten

Abstract: Patients who were scheduled at our institution for cataract surgery exhibited a high frequency of ocular as well as systemic co-morbidity. This can be interpreted in such a way that patients with a high level of co-morbidity are referred to tertiary eye care centers for cataract surgery.

Cited by 6 publications

References 3 publications

Use of Piritramide for Analgesia and Sedation during Peribulbar Nerve Block for Cataract Surgery

Use of Piritramide for Analgesia and Sedation during Peribulbar Nerve Block for Cataract Surgery

Was gibt es Neues in der Ophthalmoanästhesie?

Beeinflussende Faktoren für die Entscheidung zur Kataraktoperation — eine Pilotstudie

Contact Info

Product

Resources

About