Medicina (Mar 2021)

Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery

  • Michał Jan Stasiowski,
  • Aleksandra Pluta,
  • Anita Lyssek-Boroń,
  • Magdalena Kawka,
  • Lech Krawczyk,
  • Ewa Niewiadomska,
  • Dariusz Dobrowolski,
  • Robert Rejdak,
  • Seweryn Król,
  • Jakub Żak,
  • Izabela Szumera,
  • Anna Missir,
  • Przemysław Jałowiecki,
  • Beniamin Oskar Grabarek

DOI
https://doi.org/10.3390/medicina57030262
Journal volume & issue
Vol. 57, no. 3
p. 262

Abstract

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Background and Objectives: Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. Materials and Methods: We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (p Results: Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (p Conclusions: SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS.

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