Anaesthesia for eye surgery in paediatrics

Abstract

In contrast to adult practice, the majority of paediatric eye surgery is performed under general anaesthesia. Most patients presenting on a paediatric ophthalmology operating list will be otherwise healthy children who are suitable for day surgery. However, some children may present with eye pathology as part of a congenital disorder. The perioperative plan should be formulated after assessment of the child’s behaviour and medical comorbidities, taking into account the surgical conditions required for the intended procedure. Factors influencing intraocular pressure (IOP) may require careful manipulation, and anaesthetists should be vigilant of the oculocardiac reflex (OCR). Postoperative nausea and vomiting (PONV) is more common in ocular surgery, particularly following strabismus correction. In most cases, simple analgesics and intraoperative application of topical local anaesthesia are sufficient to provide effective postoperative pain relief.