Ophthalmologic Anesthesia: Open Eye Injuries

Anesthetic management for ophthalmic surgery in a patient with an open eye injury requires a pragmatic, evidence-based approach to optimize success. Close communication with the ophthalmologist can make a significant impact on outcome. Additionally, providing appropriate pulmonary aspiration risk reduction using established guidelines; thoughtfully managing the challenging airway; and choosing the best medications during induction, maintenance, and emergence are all critical to minimizing the risks for further eye injury. Anesthetic goals can often be in opposition to one another, but with the appropriate knowledge, experience, and effective communication between patient and surgeon, the anesthesia provider can maintain patient safety while effecting the desired surgical outcome. This review contains 2 figures, 4 tables and 37 references Key Words: awake intubation, deep extubation, emergency eye surgery, eye trauma, full stomach, intraocular extrusion, intraocular pressure, open eye injury, succinylcholine and open eye sugammadex