Anaesthesia for children with ocular injuries in a tertiary hospital
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Abstract
Background: Eye injuries in childhood are common and an important cause of non-congenital unilateral blindness. The anaesthetic management of paediatric ocular trauma deserves the special skills of the anaesthetist to improve safety. This study determined the nature of ocular trauma and the perioperative anaesthetic management of the peculiarities of the paediatric patient with eye injury.
Methods: Ophthalmic theatre registry records of surgical procedures done in the paediatric ophthalmology unit from January 1, 2017, to December 31, 2023 were reviewed. The nurses' records, case notes, and patients' anaesthetic records were examined for demographic features, nature of ocular trauma, surgical procedures, type of surgery, and others for each patient.
Results: A total of 426 children presented to the unit and 139 (32.6%) had traumatic eye injury; 40 females (28.8%) and 99 males (71.2 %). Male children were over twofold more likely to suffer eye injury (p = 0.0001, OR 2.5, 95%CI = 1.65 – 3.92). The injuries were open globe (n = 97, 69.8%) or close globe (n = 23, 16.5%) and others (n=19, 13.7%). Most of the surgeries were performed under general anaesthesia (84.9%). Tracheal intubation was achieved using succinylcholine (63.6%) or non- depolarising muscle relaxants (36.4%). Few children received premedication (18.7%) and senior registrars and consultants provided care.
Conclusion: Anaesthesia for paediatric ocular trauma should be conducted as specialized care by senior anaesthetists. The dilemma of a full stomach in a child with ocular trauma and the use of succinylcholine for tracheal intubation should be attended to with clinical prudence.
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