Anesthesia for oculoplastic surgical procedures
Operations in oculoplastic surgery may be performed under local or general anesthesia. The decision on the type of anesthesia is made by the surgeon, in consultation with the patient, based on the following criteria:
- Age of the patient
- General health of the patient
- Type of surgery
Local anesthesia requires cooperation on the part of the patient, who has to lye still during surgery. This is why it is not suitable for children. Local anesthesia is usually supplemented with sedation, in order to minimise the psychological discomfort. This approach is especially important in patients who are not suitable for general anesthesia, due to health issues.
In certain operations, local anesthesia is preferred. This is the case in adult ptosis surgery, where patient cooperation is needed to adjust the height of the upper lid.
On the other hand, operations that are lengthy and difficult to perform under local anesthesia, require general anesthesia. In such cases, preoperative laboratory tests and physical exams are needed to verify that the patient is physically fit for the operation.
Regardless of the type of anesthesia, the surgeon and anesthesiologist have to be informed about any medications the patient is on, as well as any allergies to medications.
In oculoplastic surgery, it is very important for the surgeon to be aware if the patient is taking „blood thinners“ (antiagregation and antocoagulant drugs). These drugs are used in the prevention and tretament of cardio-vascular diseases. The most frequently used among them is Aspirin, which, with the permission of the treating doctor, needs to be discontinued 14 days prior to surgery, in order to prevent uncontrolled intraoperative bleeding. Unwanted bleeding during and after the operation can also be caused by dietary supplements such as Ginko biloba and Vitamin E.