How to treat the eye after general anesthesia. Causes of vision impairment: various situations

Slight clouding of the lens is a natural part of aging. Cataracts involve a significant loss of clarity in the lens, which worsens over time. Cataract surgery is the only way to restore vision in this disease.

Before the operation, the patient is examined by an ophthalmologist, his general health is also examined, and the presence of contraindications to surgical intervention is determined.

The surgical intervention itself most often takes place on an outpatient basis under local anesthesia, taking 10-20 minutes. Most often, for cataracts, phacoemulsification surgery is used, in which, compared to the traditional technique, there is less trauma to the eye tissue, which leads to faster rehabilitation after cataract surgery.

Before the intervention, special drops are instilled into the eye, which dilate the pupil and numb the eyeball. After this, the ophthalmic surgeon makes a tiny incision in the cornea, through which the working instrument is inserted into the eye. Through this instrument, ultrasound is used to destroy the clouded lens into small pieces, which are then washed out of the eye. After removing the lens, the ophthalmic surgeon inserts an artificial lens in its place. There are no stitches placed on the incision; it closes on its own.

Most people can go home within a few hours of cataract surgery and continue their recovery.

Complications after surgery

The risk of serious complications from cataract surgery is very low. Most of them are easy to eliminate and do not have long-term effects on vision.

The risk of complications is increased in people with other eye diseases such as uveitis, high myopia or diabetic retinopathy. Problems are also more likely to occur in patients who cannot lie down easily, have difficulty breathing, or are taking medications to treat prostate problems.

The main problem that patients may encounter during rehabilitation after cataract surgery is clouding. posterior capsule lens About 10% of people develop this complication within 2 years after surgery. To eliminate it, the capsule is removed laser method, the procedure takes about 15 minutes.

Other complications are much less common.

During the intervention the following may be observed:

1. Impossibility of removing all lens tissue.
2. Bleeding inside the eyeball.
3. Rupture of the lens capsule.
4. Damage to other parts of the eye (such as the cornea).

During rehabilitation after lens replacement for cataracts, the following complications may develop:

1. Swelling and redness of the eye.
2. Retinal swelling.
3. Corneal edema.
4. Retinal disinsertion.

If there is any deterioration in vision, increased pain or redness after surgery, the patient should consult an ophthalmologist. As a rule, most complications can be eliminated with conservative therapy or surgical interventions.

Rehabilitation period

The best way to increase the effectiveness of cataract surgery is to follow all instructions for rehabilitation after cataract surgery.

A few hours after the intervention, the patient can go home; it is better to do this accompanied by a loved one or acquaintance. The patient may be slightly drowsy, which is associated with the administration of sedatives in small doses. For many people, the effects of these medications wear off fairly quickly.

Each patient after surgery is prescribed eye drops, which prevent infectious complications and speed up the healing process. They need to be used for about 4 weeks.

In the first 2-3 days after surgery, you should not overexert yourself.

During this period the patient may have:

• moderate pain in the operated eye;
• itching or watery eyes;
• blurred vision;
• feeling of sand in the eyes;
• mild headache;
• bruising around the eye;
• discomfort when looking at bright light.

It is normal to have these side effects during the early recovery period after cataract surgery. Painkillers (for example, Paracetamol or Ibuprofen) can help reduce pain, and sunglasses can help with increased photosensitivity.

Don't be alarmed if your vision seems blurry or distorted. Adaptation of the visual system to an artificial lens requires a certain time, the duration of which depends on the individual characteristics of each patient.

Typically, the person will have a follow-up visit with the doctor the day after surgery to make sure there are no complications. Full recovery takes approximately 4-6 weeks.

For safe and quick rehabilitation after lens replacement for cataracts, it is recommended:

• do not drive in the first few days;
• do not lift heavy objects and avoid intense physical activity for several weeks;
• There is no need to bend over immediately after surgery to prevent excess pressure on the eye;
• It is better to avoid using soap and shampoo;
• no need to apply makeup for 1 week;
• If possible, avoid sneezing or vomiting immediately after surgery;
• to reduce risk infectious complications Swimming should be avoided for the first few weeks;
• during the first weeks, exposure to various irritants such as dust, dirt or wind should be avoided;
• Do not rub your eyes or touch them.

To improve the effectiveness of the operation, patients should carefully follow the detailed instructions received from the ophthalmic surgeon. If any complications occur, you should immediately seek medical help.

Their symptoms are early period rehabilitation after cataract surgery are:

1. Throbbing or severe pain in the operated eye.
2. Severe headache with or without nausea and vomiting.
3. Sudden deterioration or loss of vision.
4. Increased redness of the eye
5. Sudden appearance of black dots, spots or streaks in the field of vision.

Restrictions after surgery:

Time after surgery

Allowed activity

1-2 days	The patient can get up, get dressed, walk around the house, and do light work. You can read and watch TV.
3-7 days	All moderate physical activity is permitted. You can drive a car if your vision level allows. You can't swim. Most patients can return to their jobs.
7-14 days	You can return to your normal level of daily activity except swimming.
3-4 weeks	Completion of the recovery period, discontinuation of use eye drops. During this period, vision should become better than before the operation. You can return to swimming and contact sports, but it is best to protect your eyes while doing so.

Cataract surgery is the only effective treatment for this disease. As a rule, this is a short-term and safe procedure that is accompanied by a minimum of complications.

To optimize treatment results and prevent the development of possible complications, the patient needs to follow the doctor’s detailed recommendations for rehabilitation after cataract surgery.

Useful video about cataracts

We analyze the disease of the upper eyelid - ptosis

Have you ever observed a lack of symmetry in the arrangement of eyelids in friends or yourself? If one eyelid droops too much, or both, this may indicate the presence of the following disease.

Ptosis (from Greek word- falling) of the upper eyelid means its drooping. Normally healthy person the upper eyelid overlaps the iris by about 1.5 mm.

With ptosis, the upper eyelid droops by more than 2 mm. If ptosis is one-sided, then the difference between the eyes and eyelids is very noticeable.

Ptosis can occur in any person, regardless of gender and age.

Types of disease

The types of ptosis include:

• unilateral (appears in one eye) and bilateral (in both eyes);
• complete (the upper eyelid completely covers the eye) or incomplete (closes only partially);
• congenital and acquired (depending on the cause of occurrence).

The severity of ptosis is determined by how much the eyelid droops:

• 1st degree is determined when the upper eyelid covers the pupil from above by 1/3,
• 2nd degree - when the upper eyelid is lowered onto the pupil by 2/3,
• 3rd degree - when the upper eyelid almost completely hides the pupil.

The degree of visual impairment depends on the severity of ptosis: from a slight decrease in vision to its complete loss.

What can it be confused with?

The following pathologies of the visual organs can be mistakenly mistaken for ptosis:

• dermatochalasis, which causes excess skin upper eyelids represents the cause of pseudoptosis or ordinary ptosis;

• ipsilateral hypotrophy, which is expressed in drooping of the upper eyelid following the eyeball. If a person fixes his gaze with the hypotrophied eye, while covering the healthy eye, pseudoptosis will disappear;

• the eyelids are poorly supported by the eyeball due to a decrease in the volume of the orbital contents, which is typical for patients with false eyes, microphthalmos, phthisis of the eyeball and enophthalmos;

• contralateral eyelid retraction, which can be determined by comparing the levels of the upper eyelids. It should be taken into account that covering the cornea with the upper eyelid by two millimeters is the norm;

• brow ptosis, caused by excess skin in the brow area, which can occur with facial nerve palsy. This pathology can be determined by raising the eyebrow using your fingers.

Causes of the disease

Let us examine in detail the reasons for which ptosis occurs.

Innate

Congenital ptosis occurs in children due to underdevelopment or even absence of the muscle that should be responsible for raising the eyelid. Congenital ptosis sometimes occurs together with strabismus.

When ptosis treatment is not treated for a long time, the child may develop amblyopia (lazy eye syndrome). Congenital ptosis is most often unilateral.

Acquired

Acquired ptosis develops for several reasons and is divided into:

• aponeurotic ptosis, which is associated with the weakening or stretching of the aponeurosis of the muscle that should raise the upper eyelid. This type includes senile ptosis, which is one of the processes during natural aging of the body, ptosis that appears after eye surgery.
• neurogenic ptosis associated with damage to the nervous system after diseases (stroke, multiple sclerosis etc.) and injuries. Ptosis can appear with paralysis of the sympathetic cervical nerve, since it is the muscle that innervates the levator pallidum. Along with ptosis, constriction of the pupil (or miosis) and retraction of the eyeball (or enophthalmos) occur. A syndrome that combines these symptoms is called Horner's syndrome.
• with mechanical ptosis, the cause is mechanical damage to the eyelid by foreign bodies. Athletes are at risk because eye injuries are quite common.
• false ptosis (apparent ptosis), which appears with excess skin folds on the upper eyelid, as well as hypotonia of the eyeball.

Determining the cause of ptosis is an important task for the doctor, since the surgical treatment of acquired and congenital ptosis is significantly different.

An interesting fragment from the program “Live Healthy” about ptosis of the upper eyelid

Symptoms of the disease

One of the main manifestations of ptosis is a directly drooping upper eyelid.

Highlight following symptoms ptosis:

• inability to blink or close the eye completely,
• irritation of the eyes due to the fact that there is no way to close them,
• increased eye fatigue for the same reason
• possible double vision due to decreased vision,
• the action becomes habitual when a person sharply throws his head back or tenses his forehead and eyebrow muscles in order to open his eye as much as possible and lift the drooping upper eyelid,
• strabismus and amblyopia may occur if treatment is not started on time.

Diagnosis of the disease

When identifying a drooping eyelid, which is noticeable even with the naked eye, doctors need to determine the cause of the disease in order to prescribe treatment.

The ophthalmologist measures the height of the eyelid, studies the symmetry of the position of the eyes, eye movements, and the strength of the muscle that should raise the eyelid. When diagnosing, be sure to pay attention to the possible presence of amblyopia and strabismus.

In those patients who have acquired ptosis during life, the muscles that lift the eyelid are quite elastic and elastic, so they can completely close the eye when their gaze is lowered.

With congenital ptosis, the eye cannot close completely even with the gaze lowered to the maximum, and the upper eyelid makes movements of very small amplitude. This often helps diagnose the cause of the disease.

The importance of determining the cause of ptosis is that with congenital and acquired ptosis, different parts of the visual analyzer suffer (with congenital ptosis, the muscle that lifts the eyelid itself, and with acquired ptosis, its aponeurosis). Accordingly, the operation will be performed on different parts of the eyelid.

Treatment of the disease

Neither congenital nor acquired ptosis goes away on its own over time and always requires surgery. It is better to start treatment as early as possible to increase the chances of maintaining vision, because ptosis is not only an aesthetic and cosmetic defect.

The operation is performed by an ophthalmic surgeon under local anesthesia, with the exception of children, sometimes under general anesthesia. The operation takes from half an hour to 2 hours.

Until surgery is scheduled, you can hold the eyelid open during the day with an adhesive tape to prevent strabismus or amblyopia in children.

If acquired ptosis appears due to some disease, then in addition to the ptosis itself, it is necessary to simultaneously treat the provoking disease.

For example, with neurogenic ptosis, the underlying disease is treated, UHF procedures, galvanization are prescribed, and only if there is no result, surgical treatment is prescribed.

The operation to eliminate acquired ptosis is carried out as follows:

• remove a small strip of skin from the upper eyelid,
• then the orbital septum is cut,
• cut the aponeurosis of the muscle that should be responsible for raising the upper eyelid,
• the aponeurosis is shortened by removing part of it and sutured to the cartilage of the eyelid (or tarsal plate) just below,
• The wound is sutured with a cosmetic continuous suture.

During surgery to eliminate congenital ptosis, the surgeon’s actions are as follows:

• also remove a thin strip of skin from the eyelid,
• cut the orbital septum,
• isolate the muscle itself, which should be responsible for raising the eyelid,
• perform muscle plication, i.e. put several stitches on it to shorten it,
• The wound is sutured with a cosmetic continuous suture.

When congenital ptosis of the upper eyelid is severe, the levator palpebral muscle is attached to the frontalis muscle, thereby the eyelid will be controlled by tension of the frontalis muscles.

When the operation is completed, a bandage is applied to the operated eyelid, which can be removed after 2-4 hours.

There is usually no pain during or after surgery. Sutures are removed 4-6 days after surgery.

Bruising, swelling and other effects of surgery usually disappear within a week. The cosmetic effect of the treatment remains unchanged for life.

Surgery to treat ptosis can cause the following side effects:

• pain in the eyelid area and decreased sensitivity;

• incomplete closure of the eyelids;

• dry eyes;

These symptoms in most cases disappear on their own within a few weeks after surgery and do not require any treatment. Some patients may experience subtle asymmetry of the upper eyelids, inflammation and bleeding of the postoperative wound. The cost of surgery to treat ptosis in Russian clinics ranges from 15 to 30 thousand rubles.

Strabismus can be congenital or may also result from exposure to various factors. And although some consider strabismus only an aesthetic problem, in fact, this pathology can provoke the formation of many unpleasant consequences. It is very important for the patient not only to diagnose the disease in a timely manner, but also to begin solving this problem as early as possible. Squint surgery is a radical and effective method.

Strabismus and its consequences

Strabismus is diagnosed if there are existing deviations in the parallelism of the visual axis of the eyes. More often, the patient has only one eye squinting. In some cases the deviation is symmetrical. There are several types of strabismus and there are also several ways to solve the problem: wearing special glasses, disconnecting one eye organ, surgery.

Important: Most experts are inclined to ensure that surgical intervention is performed in extreme cases. To begin with, it is recommended to try conservative methods of correcting strabismus.

What are the dangers of strabismus? Complete loss of vision of an eye organ that has abnormalities. In this case, the brain stops receiving three-dimensional images, and the images do not correspond to each other. The nervous system gradually blocks data received from the defective eye organ. His muscle tone begins to be lost. The functioning of the eye deteriorates greatly over time and amblyopia develops in 50% of cases.

Reasons for the formation of strabismus

Strabismus can be acquired or congenital. The formation of each of them has its own reasons for its occurrence. Eg.

Acquired type of strabismus

Most often, this type of strabismus develops in children before they reach six months. A significant role in this case is played by existing diseases that provoked such a side effect. But there are frequent episodes of the development of strabismus in the older century category. The most common causes of acquired strabismus are:

• strabismus as a result of sharply deteriorated vision with astigmatism, farsightedness, and myopia;
• refractive errors of the eye can be caused by developing cataracts or glaucoma, and as a result, strabismus is formed;
• paralysis of the eye muscles can cause psychological disorders, as well as somatic diseases (for example: neurosyphilis, encephalitis);
• a mild degree of strabismus can be caused by disturbances in blood circulation and sudden surges in pressure, and if the pathology is ignored, disability;
• Experts consider childhood diseases such as scarlet fever and measles to be provoking factors for the development of strabismus.

Important: In cases where the child had a predisposition to strabismus, the pathology can manifest itself as a complication after suffering from diphtheria or influenza.

Strabismus can develop in children preschool age after a strong fright, as well as as a result of psychological trauma. These reasons for the development of pathology were also recorded in older patients. Although in more rare cases.

Congenital type of strabismus

In practice, congenital strabismus is very rare. It is even less common to find it in pure form, that is, immediately at the birth of the baby. The manifestation of pathology in the first six months of a baby’s life is established as infantile. More often, a newborn has an imaginary strabismus. Children of this age are unable to accurately focus their gaze, and at the same time it seems that the child is developing a pathology.

Interesting: Imaginary strabismus can also be observed in adults when a person is in a state of severe intoxication.

Infantile strabismus often develops due to genetic disorders and during the period when the fetus is still in the womb. This can be caused by the following diseases: cerebral palsy, Crouzon or Down syndrome, as well as hereditary predisposition. In cases of heredity, one of the baby’s relatives also has similar deviations.

At risk are babies whose mothers suffered from infectious diseases during pregnancy, used narcotic drugs, as well as medications without specialist prescription.

Is surgery for strabismus the only solution to the problem?

Surgery to eliminate strabismus is a radical method of solving the problem. Immediately after diagnosis, the specialist will offer conservative treatment methods, which are more gentle methods. These may be special glasses. Their task is to force both eye organs to focus on one point. Over time, the muscles of the damaged eye develop. The pathology is gradually being corrected.

If a patient has one organ affected, an “ocular organ disconnection” procedure may be suggested. For these purposes, a special bandage is placed on the healthy eye. Thus, the brain begins to receive images only from the diseased organ. The muscles gradually develop and the pathology is corrected.

Surgery is recommended in more advanced cases. It cannot guarantee complete restoration of lost vision, but it allows for a more symmetrical relationship between the eye organs. More often, young people agree to the operation, for whom it is very important not to have external defects.

Indications for surgery

1. The patient used all conservative treatment methods, but no improvements were achieved (or they were not achieved to the maximum extent).
2. The patient wishes to eliminate cosmetic defects as soon as possible. Conservative treatment can last several months, or even years.
3. The patient has severe defects. The doctor considered it more expedient to first restore vision through surgery, and only then apply conservative methods to fix or improve the previously obtained result.

Important: The operation can be contraindicated only in cases where the patient has individual characteristics that are previously discussed with his specialist.

There are also some age restrictions. For example, the optimal age for surgical intervention is considered to be 4–5 years old for a child. Younger patients may be turned away. The exception is the congenital form of strabismus, which is corrected at 2–3 years of age. This is explained simply. After surgery, the patient must adhere to a special regime and perform special exercises. Children under 4 years old will not be able to do this consciously and independently. The chances that the pathology will return significantly increase.

Principles and types of surgery to eliminate strabismus

Surgery to correct strabismus is carried out in several types of operations. Sometimes a specialist selects one optimal option for a given situation, but more often during the operation several types are combined with each other. More details about each type.

1. Muscle recession involves cutting off tissue from its physiological attachment point. After cutting, the muscle is sutured. The specialist selects the optimal location for its future attachment. This may be a tendon, as well as the sclera. As a result, the fiber moves back and its effect weakens. If the fiber moves forward, the action of the muscles, on the contrary, increases.
2. The myectomy operation involves similar manipulations with cutting off the muscle. The difference from the previous type is the absence of a suturing procedure.
3. Less trauma to the eye organ can be achieved using Faden surgery. In this case, manipulations with cutting off the muscle are not performed. The tissue is immediately sutured to the sclera. This procedure uses non-absorbable threads.
4. If a muscle is weakened and its action needs to be strengthened, shortening surgery is used. During surgical intervention part of the muscle is removed.
5. Another type of operation will help to obtain a similar effect. It involves creating a fold between the tendon and muscle. It is possible that this fold is formed inside the body of the muscle itself.

Any of the selected operations to correct strabismus is carried out in compliance with the main principles. The correction must be gradual. The operation is performed on only one eye organ. On the second, the procedure is repeated several months later (approximately 3–6). Although, with a small mowing angle, the surgeon may decide to make corrections simultaneously in both eyes, but this is often the exception.

Features of the operation

If the patient has severe strabismus, surgery is performed in several steps. The fact is that it is undesirable to perform surgery on more than two muscles at a time.

Lengthening or shortening a muscle must be carried out evenly on all sides. For example, if the muscle on the right contracts in size, then on the left it must necessarily increase. In this case, the dimensions of excision and enlargement are necessarily identical.

Observing all the main principles of surgical intervention, the specialist tries to preserve as much as possible the connection between the eyeball and the operated muscle.

For adult patients, the correction is performed under local anesthesia. Upon completion, the patient is given a bandage. You can go home after just a few hours. For children (of any age), general anesthesia is always used. IN mandatory the child is hospitalized for a day, but cases with a longer hospital stay cannot be excluded.

Those who have the opportunity to correct pathology in foreign clinics should pay attention to German and Israeli specialists. Their approach to such correction is more radical. Almost all types of pathologies are corrected in one visit. Another plus is the possibility of performing the operation on children under one year old.

Rehabilitation period

Although the operation to correct strabismus is performed in one day and the patient is immediately sent home, this does not mean that there is no rehabilitation period. To quickly restore binocular vision, you will need to adhere to certain doctor’s recommendations for some time and perform special eye exercises.

The first day after surgery, the eye organ will be sore, slightly red and inflamed. This is a natural state. There may also be a short-term deterioration in vision. During this period, every movement must be controlled, since any attempts to touch the eye can only result in increasing pain.

Important: Restoration of the tissues of the eye organ and binocular vision occurs after a month. Most patients see a double picture all this time. If vision is not restored after this period, you should consult an ophthalmologist.

In children, adaptation time is significantly reduced. The main thing is to perform the exercises prescribed by a specialist and visit an ophthalmologist.

For active recovery, a specialist may recommend using special corrective glasses, as well as covering the healthy eye from time to time. This will help create stress on the operated organ. The muscles will develop faster and reach the desired level.

What complications should you expect after surgery?

The most common complication that occurs in medical practice after surgery to eliminate strabismus is overcorrection. It is formed when the muscles of the eye organ are excessively lengthened or sewn in. The main reasons for this undesirable effect:

• surgeon error;
• incorrect preliminary calculations;
• the patient’s natural growth, which affects the increase in size of the eye organ.

IN Lately experts have found the best way to minimize the risk of such a complication. Increasingly, operations are being carried out not by cutting, but by sewing in muscle folds. In this case, the applied suture is adjustable and the undesirable effect can be corrected in a minimally invasive way.

Formation of a rough scar at the site of muscle cutting and subsequent reattachment. This method of surgical intervention deprives the muscle tissue of mobility and elasticity, which is partially replaced by fibrous tissue. The only alternative to this moment is to reduce the size of the excised area.

Strabismus returns (relapses) over time. This complication most often occurs due to the fault of the patient himself, who neglects to comply with all the rules in the postoperative period. In children, relapse can occur due to sudden increases in load on the eye organ. For example, an operation to correct strabismus was performed at the age of five or six years, and after a couple of months the child began to attend school.

The most serious, but very rare complication is damage during surgery. vagus nerve responsible for the functioning of the lungs, gastrointestinal tract and heart muscles.

Patient reviews

Mostly a lot negative reviews You can hear from parents who decided to have their child have surgery in domestic clinics. They justify their dissatisfaction with the following comments.

1. Most clinics do not have individual approach to each patient and existing problem.
2. Refusal of specialists to perform surgical intervention in early age, and delay results in progression of the disease and deterioration of vision for the little patient.
3. Basically, all clinics use outdated techniques and equipment during operations and diagnostics. This does not make it possible to get a 100% result from the first operation. Correction of strabismus is performed with insufficient results and repeated attempts must be made over time. surgical interventions.
4. There are few specialists in this profile, which greatly limits patients’ choices.

Most parents note only a temporary positive result. As soon as it starts academic year and the child goes to school, vision begins to fall again, and the squint returns. This is explained by an increase in eye strain. Many children refuse to wear special corrective glasses at school. To prevent their classmates from laughing, they take them off and hide them secretly from adults. Less time is devoted to special exercises. All these negative factors lead to the fact that young people decide to have a second operation only after graduating from school.

Important: The older the patient, the less successful the surgery to correct strabismus is.

How much does surgery to correct strabismus cost?

The cost of surgery to correct strabismus differs in different clinics. For example, if this government agency and the child is a minor, the operation can be performed free of charge. Treatment will also be free for adults, but only those who have a compulsory medical insurance policy. It is also worth noting that some private clinics also work with compulsory health insurance. The operation itself will be free, but additional services may be required that will need to be paid for.

In the case of other private clinics, the price can vary within 20,000 thousand rubles. The price varies depending on the availability of modern equipment in the institution, the professionalism of the doctor, the complexity of the operation itself, etc.

Patients who are thinking of going to a German or Israeli clinic will have to count on about 7 thousand euros. But there is also one nuance here. Visiting a foreign clinic through an intermediary will increase in price (about 2 times).

What brands of contact lenses are you familiar with?

Eye surgery to correct strabismus

Often, strabismus surgery does not immediately return normal vision. Many will agree that it is a pity to look at a young, pretty girl or child looking askance. Without this cosmetic defect everything would be fine. In addition, ophthalmologists recommend trying conservative methods of treating strabismus before going under the knife.

What is strabismus, or strabismus?

Strabismus is a pathology in which one, both, or alternately the right and left eyes deviate from the normal position when looking straight. When a person looks at an object, the information received by each eye is slightly different, but the visual analyzer in the cortical part of the brain brings everything together. With strabismus, the pictures are very different, so the brain ignores the frame from the squinting eye. The long-term existence of strabismus leads to amblyopia - a reversible functional decrease in vision, when one eye is practically (or completely) not involved in the visual process.

Strabismus can be congenital or acquired. Newborns often have a floating or sideways gaze, especially after a difficult birth. Treatment by a neurologist can remove or alleviate the manifestations of birth trauma. Another cause may be a developmental abnormality or improper attachment of the extraocular muscles (see Fig. 1).

Acquired strabismus occurs as a result of:

infectious disease: influenza, measles, scarlet fever, diphtheria, etc.; somatic diseases; injuries; a sharp drop in vision in one eye; myopia, farsightedness, high and moderate astigmatism; stress or severe fear; paresis or paralysis; diseases of the central nervous system.

How can you get rid of strabismus?

Strabismus corrects:

wearing special glasses; a series of eye exercises; wearing a blindfold covering one eye; surgery for correcting strabismus.

Variable strabismus, when sometimes the right or left eye squints, is tried to be corrected by wearing a bandage. Long-term use of specially designed glasses often helps. Exercises to strengthen the ability to focus are recommended for almost all patients with strabismus. If all of the above methods do not correct vision, surgery is performed to correct strabismus. This type Surgery is performed both in infancy and in adulthood.

Types of surgeries to correct strabismus

The following types of strabismus occur in children and adults:

• horizontal - converging and diverging relative to the bridge of the nose;
• vertical;
• combination of two types.

Doctors encounter convergent strabismus more often than divergent strabismus. Along with converging strabismus, the patient may have farsightedness. Myopic people usually have divergent strabismus.

During the operation the following can be performed:

amplification type surgery; debilitating surgery.

In weakening surgery, the eye muscles are transplanted a little further from the cornea, which tilts the eyeball in the opposite direction.

During augmentation surgery, a small piece of the eye muscle is removed, causing it to shorten. This muscle is then sutured to the same place. Surgery to correct strabismus involves shortening and weakening the target muscles, which restores balance to the eyeball. The operation is performed on one or both eyes. The microsurgeon determines the type of surgical intervention when the patient is in a completely relaxed state on the operating table.

In some clinics, the operation is performed under local anesthesia only for adults. and in others, all patients are given general anesthesia. Depending on age, health status and other factors, mask (laryngeal), endotracheal anesthesia using muscle relaxants, or an alternative type of anesthesia is performed.

It is important that during surgery the eyeball is motionless and there is no tone in the muscles, because the surgeon is special test: It evaluates the degree of restriction of eye movement by moving it in different directions.

After surgery, an adult can go home on the same day. The child needs preliminary hospitalization. Most often, mothers are in the hospital with their children; discharge occurs the next day after the operation. The recovery period takes about 14 days. After discharge, the patient extends sick leave or a certificate from your clinic.

It should be noted that in 10-15% of cases, strabismus is not completely eliminated and repeated surgery may be necessary. Surgery using adjustable sutures helps reduce the failure rate. After the patient wakes up, the doctor checks the condition of the eyes after some time under local anesthesia. If there are deviations, he slightly tightens the suture knots and only then finally secures them. All types of operations are performed with completely absorbable suture material.

Adults who have lived for a significant period of time with strabismus sometimes experience double vision after surgery because the brain is unaccustomed to perceiving a binocular image. If before the operation the doctor has determined that there is a high probability of developing double vision, the correction of strabismus is done in two stages so that the brain can gradually adapt.

Carrying out the operation

A few days before surgery, you need to take blood tests, do an ECG and undergo a consultation with some specialists. You should not eat 8 hours before surgery. If it is scheduled for the morning, you can have dinner, and if it is in the afternoon, then a light breakfast is allowed. The child and mother are admitted to the hospital a couple of days before the operation. The procedure is performed under general anesthesia. The operation itself lasts 30-40 minutes, then the patient is taken out of anesthesia and transferred to the ward. All this time, a bandage is placed on the eye. After the operated patient has completely recovered from anesthesia, he is examined by a surgeon in the afternoon. He opens the bandage, checks the eye, puts in special drops and closes it again. After this, adults are sent home with detailed recommendations: what medications to take, what to put in their eyes, and when to come for a second examination. The eye patch is left until the next morning. After a week, you need to come for an examination, where the doctor will assess the speed of healing and the condition of the eye. The final assessment of eye position is carried out after 2-3 months.

For several weeks after surgery, special anti-inflammatory drops and (if necessary) antihistamines are used. The eye will be red and swollen. Sometimes the next morning the eye will stick together due to accumulated pus. There is no need to be scared: it is washed with warm boiled water or sterile saline solution. For a couple of days the eyes will be very watery and sore, and it will also seem as if there are specks in the eye. The sutures dissolve on their own after 6 weeks.

For a month after surgery, you need to carefully protect your eye. You cannot swim, stay in dusty areas or play sports. Children at school are exempted from physical education for six months.

A month after the operation you need to undergo a course of treatment. To regain the binocular ability to see and recognize the correct picture, you need to undergo a special hardware treatment V medical center. Some clinics have the Amblicor complex, developed by specialists from the Brain Institute. Treatment using this device is a computer video training. It helps overcome the skill of suppressing vision in one eye. While watching a cartoon or movie, an EEG of the visual cortex of the brain and readings about eye function are continuously taken from the patient. If a person sees with both eyes, the film continues, and if only with one, it pauses. Thus, the brain is trained to perceive the image from both eyes.

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Anesthesia during surgery to eliminate strabismus - medical article, news, lecture

Strabismus is visually defined as a deviation of the axis of the eyeball. The disease predominantly affects children (2-5% of the child population). Strabismus may involve one or both eyeballs, turning them inward, outward, upward, or downward. Although correction can be performed at any age, the results of surgery at an early age are better, with the most positive results usually occurring in children under 6 years of age, especially those under 2 years of age. Surgery is only one of the possible ways treatment of strabismus. Other methods include wearing special glasses or an eye patch. Strabismus surgery involves extraocular interventions that involve repositioning the eye muscles that cause the deviation. The operation can be performed on one or both sides.

Anesthesia for strabismus surgery

Correction of strabismus is the most common operation in pediatric eye surgery. It is usually performed under general anesthesia (always in children), although local anesthesia can sometimes be used successfully in adults. There are several ways to carry out general anesthesia in strabismus surgery. Endotracheal anesthesia with muscle relaxants is usually used, but the use of a laryngeal mask airway (LM) for anesthesia is also quite popular. It is very important that the eye remains still during surgery. This is because the surgeon requires a complete absence of muscle tone to perform the forced duction test (FDT). It involves assessing the mechanical limitation of eyeball movement by forcing it to move across all visual fields, performed by grasping the sclera near the corneal edge with two forceps. This test allows the surgeon to differentiate myoparalytic restriction of eyeball movements from mechanical restriction. Due to the fact that muscle tone can vary widely depending on the depth of anesthesia, some surgeons prefer to perform the operation under the influence of muscle relaxants.

Preoperative preparation for strabismus removal surgery

For children, it is enough to premedicate with paracetamol 20 mg per kg, and you must first obtain parental consent for the rectal use of NSAIDs in suppositories. In older children who are scheduled to undergo surgery under general anesthesia, routine examinations are performed. Premedication is performed using glycopyrrolate (200 mcg in adults, 5 mcg/kg in children), which can reduce salivation, which is especially useful when using a laryngeal mask airway (LMA). The drug also helps reduce the frequency of the oculocardial reflex.

Induction of anesthesia during strabismus removal surgery

Tactics depend on whether the patient is under the influence of muscle relaxants or breathing spontaneously through a laryngeal mask airway (LM).

Most often, intravenous induction is performed with fentanyl or alfentanil in combination with propofol or thiopental. Induction with the inhalational anesthetics halothane or sevoflurane can also be used successfully, especially in young children.

The choice between laryngeal mask airway (LMA) and tracheal intubation depends on several factors. Given that the laryngeal mask airway (LMA) is more likely to cause problems in young children, some anesthesiologists prefer to use endotracheal anesthesia in them. Typically, when using a laryngeal mask airway (LMA), the patient breathes spontaneously, although it is also possible to use artificial ventilation. In the latter case, increasing inspiratory pressure (more than 15 cm of water column) should be avoided in order to minimize the possibility of gastric inflation with air. The use of a reinforced laryngeal mask airway (LMA) is more likely to produce positive results than the use of a traditional laryngeal mask airway (LMA). A common contraindication for the use of a laryngeal mask airway (LMA) is uncontrolled reflux. It should also be remembered that during strabismus surgery, access to the airway is difficult, so you should ensure that the airway is secure until the patient is covered. To ensure tracheal intubation (usually reinforced tubes - RAE) are used, it is preferable to use non-depolarizing muscle relaxants rather than suxamethonium. There are two reasons for this. First, the patient has a prolonged increase in extraocular muscle tone after suxamethonium administration, which interferes with the FDT test. This effect lasts approximately 15-20 minutes. Second, a patient undergoing strabismus correction surgery may be at risk for developing malignant hyperthermia.

Maintaining anesthesia during strabismus surgery

Correction of strabismus usually lasts 60-90 minutes in the supine position. Anesthesia can be maintained with either a volatile anesthetic (with or without nitrous oxide) or propofol infusion. Due to the fact that this type of surgery is not very painful, a combination of paracetamol/NSAID with fentanyl or alfentanil should be considered an adequate combination. As an addition, local anesthesia can be used.

Like all operations in eye surgery, this intervention carries a risk of developing an oculocardial reflex (OCR). It is most often observed in children or adolescents undergoing strabismus correction. The oculocardial reflex (OCR) is characterized by a noticeable slowing of the heart rate, the appearance of cardiac arrhythmias in response to traction of the extraocular muscles or pressure on the eyeball. In extremely rare cases, cardiac arrest may occur. This reflex is mediated by the excitation of the vagus and trigeminal nerves. The reflex is more noticeable with sudden and sharp traction than with careful and gradual traction. The intensity of the oculocardial reflex (OCR) decreases with subsequent stimulation. Due to the importance of the oculocardial reflex (OCR), special attention should be paid to the need for its prevention and elimination. Although the dose of glycopyrrolate administered at the time of induction (200 mcg in adults, 5 mcg/kg in children) provides some degree of protection against oculocardial reflex (OCR), it cannot be completely eliminated in all patients. Typically, premedication with glycopyrrolate avoids the need for subsequent administration of anticholinergic drugs (atropine). If the patient exhibits significant oculocardial reflex (OCR) with bradycardia or arrhythmias, atropine is the drug of choice for rescue therapy. In such situations, the surgeon should be informed, and releasing traction will help return the heart rate to its original level. Side effects associated with the administration of anticholinergic drugs, such as dry mouth and tachycardia, also need to be taken into account.

Simple techniques such as additional use of local anesthetics and avoidance of hypercapnia can also reduce the incidence of oculocardial reflex (OCR).

Postoperative management during strabismus surgery

As mentioned earlier, strabismus correction surgery is not a painful procedures. In this regard, you can stop using opioids. This will reduce the incidence of postoperative nausea and vomiting. Their appearance is especially typical for strabismus correction operations, and therefore the issue of prophylactic use antiemetic drugs.

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Strabismus

The ultimate goal of strabismus surgery is to restore symmetrical (or as close to symmetrical) eye position as possible. Such operations, depending on the situation, can be performed both in adults and in children.

Types of surgeries to correct strabismus

In general, there are two types of operations for strabismus. The first type of operations is aimed at relaxing excessively tense extraocular muscle. An example of such operations is recession (crossing a muscle at its insertion and moving it in such a way as to weaken its action), partial myotomy (partial excision of part of the muscle fibers), muscle plastic (for the purpose of lengthening). The second type of surgery is aimed at strengthening the action of the weakened extraocular muscle. An example of operations of the second type is resection (excision of a section of weakened muscle near the attachment site with subsequent fixation of the shortened muscle), tenorrhaphy (shortening of the muscle by forming a fold in the muscle tendon area), anteposition (moving the site of muscle fixation in order to enhance its action).

Often, during surgery to correct strabismus, a combination of the above types of surgical intervention (recession + resection) is used. If, after surgery, there is residual strabismus that is not leveled by self-correction, repeated surgery may be required, which is usually performed after 6 to 8 months.

To achieve maximum effectiveness when performing surgery to correct strabismus, you must adhere to several basic principles.

1. Unnecessarily speeding up the process of surgical correction of strabismus often leads to unsatisfactory results. Therefore, all manipulations should be carried out in doses (if necessary, in several stages).

2. If it is necessary to weaken or strengthen individual muscles, dosed surgical intervention should be distributed evenly.

3. When performing surgery on a specific muscle, it is necessary to maintain its connection with the eyeball.

High-tech strabismus surgery:

Specialists from children's eye clinics have developed modern high-tech radio wave surgery using the principles of mathematical modeling.

Advantages of high-tech eye surgery:

1. The operations are low-traumatic; thanks to the use of radio waves, the structures of the eye are preserved.
2. After the operations there is no terrible swelling, the patient is discharged from the hospital the next day.
3. Operations are precise.
4. Thanks to the principles of mathematical calculation, we can ensure the highest accuracy and show the guaranteed result of the operation even before it is carried out.
5. The rehabilitation period is reduced by 5-6 times.
6. Weakening. During this type of surgery, the site to which the muscle is attached is transplanted to a further distance from the cornea. Due to this, the influence of the muscle tissue that deviates the eye from the center of the axis is weakened.
7. Strengthening. This operation removes strabismus by excision (shortening) of the muscle, while its location remains the same.

It should be noted that what type of surgical intervention will be performed is determined only during treatment by an ophthalmologist.

It takes many factors into account:

patient's age; features of the location of muscle fibers; angle of strabismus; general state and features of eye movement, etc.

In most cases, correction affects several muscle groups at once (especially when it comes to adult patients), and sometimes both eyes require surgical intervention.

If the ophthalmologist decides to combine two methods of surgery, it is often done in stages.

Features of surgical treatment of strabismus depending on age

Often, surgery to correct strabismus in adults is performed under local anesthesia. After this, the patient spends no more than one day in the clinic under the supervision of medical workers.

The correction made gives a positive result. But in practice, after surgery, unpredictable behavior of muscle fibers is possible, which can lead to residual strabismus. This occurs more often in adult patients, so it is often prescribed re-treatment or a set of exercises that are aimed at stabilizing the work of the eye muscles. The next surgical intervention is scheduled no earlier than 6 months later.

To ensure the best effectiveness of surgical intervention in adults, a person needs to fulfill a number of conditions:

if the doctor has decided that the correction should be gradual, one should not insist on the opposite and rush things; fully adhere to all post-operative instructions given by the medical staff; For adult patients, it is advisable to carry out simultaneously weakening and enhancing measures.

Surgical intervention is aimed at correcting the position of the eye; it should not disrupt the connection between the eyeball and the muscles.

The most optimal age for such correction in children is considered to be from 4 to 5 years. Congenital strabismus is characterized by a significant angle of deviation of the eyeball from the center, so surgical intervention can often be prescribed earlier. But the time when the child, after surgery, consciously understands and does the exercises prescribed by the doctor is considered more effective and efficient.

Unlike the course of surgery in an adult patient, general anesthesia is used for a child, and the period of hospitalization, depending on the condition, can be extended by several days.

Are there complications?

Strabismus surgery, like any other surgical procedure, has its own postoperative complications. But it should be noted that the capabilities of modern ophthalmology (minimally invasive and carried out with a laser) have significantly reduced the possibility of their occurrence.

One of these complications, which in principle is not such a thing, is considered to be residual strabismus. After a successful operation, only 15% of the total number of patients may experience this condition.

The intervention itself does not affect visual acuity in any way, since it affects only the muscle group that regulates eye movement.

Of course, it cannot be ruled out that an infection may occur during the operation. But to avoid this, doctors prescribe drops containing an antibiotic, which promote normal healing and prevent the development of pathogenic microflora. Therefore, the percentage of such complications is very low.

If during the postoperative period the patient complains of double vision (diplopia), then this condition cannot be called a complication. This is a completely normal condition that passes over time and indicates a restructuring of the body and the restoration of binocular vision. In some cases, for faster recovery, the patient is prescribed hardware treatment.

Surgical intervention aimed at correcting strabismus will help anyone get rid of this aesthetic problem and will not affect visual acuity in any way. Therefore, there is no need to be afraid of this.

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A few questions about concomitant strabismus and surgery

Hello. I am 26 years old (almost 27 in a few days).

About a year ago, concomitant strabismus appeared. Until this moment, nothing like this had happened, although 5 years ago, during an examination, the doctor found a strabismus with a minimal angle, but said that it was not significant and the vision was binocular, it was not visible visually.

Why it appeared so suddenly - I don’t understand at all, there is only an assumption that it is connected with neurology - since childhood I had a disease with tics, which they could not diagnose, I went through a lot of examinations to no avail. As I grew older, the tics went away. Although spontaneous twitching of the fingers occurs periodically, for example. And at the time strabismus began to appear, there was a certain pulsation in the eye, very reminiscent of muscle contraction, and this was more so in the healthy eye, which is now dominant. The pulsation then appeared for a long time, but only disappeared in the last few months.

I contacted the Excimer center. We carried out an examination, unfortunately, I cannot post the data, because... I don't have it in my hands.

The doctor also said that you need to start using a squinting eye, about two hours a day, then the image sharpness on it will gradually return to the level strong eye. Although during the examination I saw the smallest letter “w” with both eyes, but still, if with the healthy eye I saw clear contours, then with the squinting eye it was blurry.

1) Is it true that if I wear an eye patch for several hours a day (which, in principle, is not a problem for me at all), then the sharpness will completely return to the squinting eye and, at a minimum, it will not get any worse. Until that time, I had almost completely used my left eye, not the squinting one. (maybe this is all too subjective, but I already notice some improvement in sharpness on my squinting eye after I started wearing the bandage).

2) Regarding the bandage, they generally talk about stickers. But it’s very uncomfortable for me, and even with the left eye closed for a long time, and right eyelid He also tries to close himself all the time, his eyes are watering. I made a dark headband with an elastic band. in it the eye is open and a little light comes from below and from the edge, even with peripheral vision a little silhouettes are visible, but still only the squinting eye works. Is it enough to wear such a bandage? My eye is open in it, but I don’t feel any particular discomfort.

3) Actually about the operation itself. It scares me a little that they will operate on two eyes at once. I work on the computer quite a lot. Although the doctor said that visual functions are not affected in any way and the eyes can be used immediately after the operation. But, at a minimum, they cut the muscles, how am I going to move my eyes, it probably hurts, or am I mistaken? How fast can I work on the same computer?

5) Actually main question, but do I need an operation, especially since apparently two of them will be required, again in half a year, so at least I was warned. I was told. that after surgery and completing a 10-day hardware course, there is a high probability of obtaining binocular vision. Here I am a little doubtful whether all this is worth doing at all. The cosmetic effect does not play a role for me (although they warned that the squint will only increase further due to the very low counter-reaction, or whatever it is called).

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Operation. What kind of anesthesia is given?

Many people have undergone surgery due to a serious illness or accident. When the operation was performed, most of them had no idea what type of anesthesia was used. But patients who have the right to choose - to lie on the operating table or to eliminate the problem that has arisen in the body using other methods, often think about how doctors will relieve them of pain and, in general, from perception unpleasant procedure. In this case, it is recommended to contact a professional anesthesiologist. But if you do not have this opportunity, then I recommend reading this publication to the end in order to have an idea of ​​​​what is happening to the patient in the surgical room.

I decided to write this article because I received a letter from a reader of the site posowetuite.ru. She is about to have an operation, but she does not know what type of anesthesia is used in this case. Read her message to get an idea of ​​what kind of problem this woman had:

Hello! Please tell me, what kind of anesthesia is best to perform the operation to remove a tumor in the mammary gland? I went to three doctors, everyone said different things...

As is clear from her treatment, she is disoriented because the doctors give her different answers. I think it would be advisable to address her question directly to an anesthesiologist, and preferably to one who has a lot of experience.

At what age can general anesthesia be given if surgery is necessary?

Before answering a woman’s question - what type of anesthesia is used when surgery is performed to eliminate a tumor in the mammary gland, let’s consider the most frequently asked question about the age at which general anesthesia is performed. The answer to this will be the statement - in fact, there are no specific boundaries between the age at which general or local anesthesia begins and when it ends. It may be needed in the most different situations. Sometimes people have babies who need emergency surgery, and old people end up on the operating table quite often.

There is always a risk of general anesthesia, as well as local anesthesia. Causes:

Uneducated and inexperienced anesthesiologist;

Wrong dose;

Allergic reaction of the body;

Intolerance to some substances;

Weakness of the heart or any other vital organ.

Therefore, before deciding to have an operation, you should ask the doctor or anesthesiologist to clarify what kind of anesthesia they administer, and then ask to determine whether your body accepts the substances contained in painkillers. This is almost a guarantee that nothing will happen to you during surgery and the operation will take place without serious consequences.

What diseases cannot be treated with anesthesia if surgery is to be performed?

As mentioned above, when agreeing to undergo surgery, you need to find out at the clinic what type of anesthesia they use. It can be general or local. And only then, you should ask in what cases it is contraindicated. Anesthesiologists believe that if an operation is to be performed, general anesthesia should not be used in children if the child:

Treated for acute illness respiratory tract;

Sick from severe rickets;

Suffering from hyperthermia of unknown origin;

Has purulent rashes on the skin;

He was vaccinated less than ten days before the operation, in this case it is also important what vaccination he received.

In the case of adults, anesthesiologists do not perform anesthesia when:

The patient suffers from neurological and psychiatric diseases;

The patient suffered an acute myocardial infarction a couple of months before the operation was to be performed;

A person has heart rhythm disturbances;

If the patient suffers from stable or unstable angina;

If the patient has diastolic pressure;

Severe stenosis of the mitral or aortic valves is observed;

There is uncompensated heart failure;

The patient experienced an exacerbation bronchial asthma or bronchitis;

The patient suffers from pneumonia;

The patient developed an acute respiratory tract infection.

You probably don’t know what kind of anesthesia is used if an operation is performed in the lower part of the body. Usually this is epidural and spinal anesthesia. Contraindications to them are:

Allergy to the anesthetic or its components;

Hypovolemia – reduced filling of blood vessels, this occurs with dehydration or severe blood loss;

Poor blood clotting;

Increased intracerebral pressure.

It should be clarified that epidural anesthesia is the insertion of a tube through which an anesthetic drug is delivered into the epidural space of the spine. Spinal anesthesia is the numbing of nerves in the spine using appropriate medication. Which one the anesthesiologist chooses depends on his preferences and the doctor’s recommendations.

When an operation is performed because it is necessary to save the patient's life, for example, if there has been an accident or cancer tumor began to progress, doctors do not pay attention to contraindications. Indeed, in this case, general anesthesia is simply necessary so that the victim does not die from painful shock. The patient, like his relatives, will not be able to find out what kind of anesthesia is given in this case. And the point here is that doctors try to react quickly, choosing the lesser of two evils. You can't blame them for that.

If you are planning an operation in which general anesthesia is not performed, but local anesthesia must be performed, then you should know what contraindications there are to the latter. This procedure cannot be carried out for the following reasons:

When observed serious disease liver;

If the operation requires the administration of anesthetic in large quantities;

When the patient suffers from epilepsy;

With pseudocholinesterase deficiency.

If at least one of the above points is observed in you, and you are about to undergo surgery, then you need to tell your doctor the information he needs so that the anesthesiologist knows which drug is best to use or what anesthesia to administer.

What types of anesthesia are used when surgery is performed?

In this part of the article we will look at the types of anesthesia. It happens:

1. General. She is anesthesia. When it is done, consciousness and the body’s reaction to stimuli of any nature are switched off. Usually after this procedure the patient does not remember anything about what happened in the surgical room.

2. Regional. These include epidural, spinal and conduction. The first two were described above. The third is the blocking of nerve transmission in a specific area of ​​the body, which entails anesthesia and immobilization that lasts the entire time the operation is performed.

3. Local. When performing it, an anesthesiologist or doctor injects an anesthetic into a specific place, which makes it numb.

4. Sedation. It is carried out for examinations that can cause pain. Typically, sedation involves administering a small amount of the drugs used for general anesthesia.

Preparations for anesthesia and anesthesia. Which is better?

Anesthesiologists use a number of drugs to ensure patients have pain-free surgery. The most commonly used drugs used to induce anesthesia are listed in this part of the publication. Let's start with inhalational anesthetics. Their list:

Nitrous oxide, also called laughing gas;

Isoflurane;

Sevoflurane;

Desflurane;

Only doctors can determine which of them will not harm you and which is harmful.

There are anesthetics and non-inhalational ones, that is, medications that are introduced into the body before the operation begins. These include:

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strabismus surgery

Hello! A strabismus operation is coming up, how is it performed (under general or local anesthesia?) and will there be bed rest on the first day? When can you walk and work with a computer? Thank you.

Under local anesthesia (injection under the eye). There will be no bed rest. Sit down at the computer whenever you can. During the first week, the operated eye will quickly get tired, watery and afraid of light.

Good afternoon Several years ago I had surgery to correct my strabismus. Then the left eye squinted towards the bridge of the nose, but now, on the contrary, towards the temple. Both eyes were operated on. Is it possible to put the eyeball back in place so that both eyes look straight? What anesthesia is the operation performed under? Do any of your specialists travel to Perm for consultations? If yes, which clinic? How much does the operation cost? Thank you in advance.

The ability to help can be assessed during a face-to-face consultation, and sometimes only on the operating table. In adults, correction of strabismus is carried out against the background of an anesthetic injection (local anesthesia). The cost of the operation in our clinic is 10,350 rubles. For consultations in your region, contact our representative.

Hello! I am having surgery to correct my strabismus. Please tell me how it goes. and whether there will be scars after surgery. thank you in advance!

It's very simple. You are given a painkiller injection. The conjunctiva is cut. The operated eye muscles are isolated, their attachment points are shortened or transplanted. The conjunctiva is sutured. That's all. Scars are not visible 1-2 months after surgery.

Hello! You can find out whether adults undergo surgery to correct strabismus under anesthesia.

For adult patients, the operation is performed under local anesthesia (injection under the eye). For increased anxiety and agitation, use sedatives. General anesthesia is used as an exception.

Hello, I’m 19 years old, my left eye is squinting, they told me when I’m 18 years old, come to Kaluga and we’ll do the operation, they didn’t do the operation for my strabismus. They said that the cornea is thin, how is that so? how to thicken it? If my cornea remains thin all my life, then I won’t see surgery?

For surgery to correct strabismus, the thickness of the cornea does not matter. You were probably denied laser vision correction. Unfortunately, it is impossible to “increase” the thickness of the cornea no matter how much you want. For patients with thin corneas, certain vision correction techniques, such as IntraLasik or Epi-Lasik, may be indicated. To determine the possibility of surgical treatment, an in-person consultation is necessary.

Hello, I'm 21 years old. I’m going to have surgery to correct the squint in my right eye, but my vision is also poor; it can be corrected right away or something.

In principle, such operations are carried out simultaneously. However, their necessity and possibility will be determined after an in-person examination.

Hello. I am 32 years old. My right eye is squinting towards my temple. This makes me very uncomfortable when communicating with people. Please tell me, is it possible to correct strabismus at this age? What is the success rate of the operation? What is the price?

Squint surgery is possible. Cost - 12,200 rubles. The effectiveness of surgical treatment approaches 95%. Sign up for a consultation on the website.

Hello, I’m 14 years old and I have squint, I would really like to fix it. I went to the hospital and trained him, they taped up the eye in which I can see well, and with the oblique one I kept an eye on all sorts of balls. in the end it didn't help. the eye squints towards the temple. I was told that if I have surgery, my eye might go to my nose. please tell me whether it is possible to do the support and how much it will cost, thank you.

The operation can be done. With correct manipulations eye muscles, there will be no hypereffect.

The cost of correcting strabismus in our clinic is 12,800 rubles. Sign up for diagnostics and possible surgical treatment on the website.

Hello, I'm 18 years old. The left eye has been squinting since 7 months. I wanted to know if surgery to correct strabismus was recommended for me (I was denied vision restoration). And if so, how long will the effect last? My full diagnosis: “severe amblyopia in the left eye.” Partial atrophy of the optic nerve, hypertrophy of the highest degree of the left eye. Converging concomitant strabismus of the left eye.” Thank you in advance.

Strabismus can be corrected. The cosmetic effect lasts on average 3-6 years. In case of relapse, repeat surgery is performed.

Hello, I would like to know. Since childhood, strabismus in the left eye. In the 4th grade, the eye magically “falls into place,” but when examining any objects or looking at a person close up, the eye runs into the corner. Is it possible to have an operation in such a situation and what will it involve?

Source:

Strabismus or strabismus is a shift in the focus of one or both eyes and a resulting disturbance in binocular vision. The disease can be caused by various factors. Sometimes it is congenital, sometimes there is only a predisposition, and strabismus occurs as a result of infection or stress.

There are several methods of treating the disease - wearing special glasses, “temporarily” turning off the healthy eye, surgery. Operation for strabismus is reduced to correcting the position of the eye: intensifying weak muscles, fibers that are too short are lengthened.

Indication for surgery

Surgery is most effective when childhood. If it is acquired, the optimal age is 4-6 years. In congenital forms of strabismus, the operation is performed somewhat earlier - at 2-3 years. In adults, it can be performed at any age in the absence of general contraindications.

• The patient’s desire to eliminate a cosmetic defect in himself or his child.
• The entire arsenal of conservative methods was used, but the achieved improvement in binocular vision was not maximum.
• The doctor believes that it is advisable to create conditions for restoring vision through surgery. That is, surgery is prescribed first, and then additional correction using conservative methods. This appointment is possible in case of too severe strabismus.

Carrying out the operation

Types of surgery

There are several fundamentally different types of surgical intervention, which are often combined in one operation:

1. Recession of the extraocular muscle. During the procedure, the surgeon cuts away the tissue at the site of its attachment. After this, the muscle is sutured to the sclera or tendon. As a result, the fiber is moved backward and thus its effect is weakened. If the movement is made, on the contrary, forward, the action of the muscle intensifies.
2. Myectomy. This operation also involves cutting off the muscle, but without subsequent stitches.
3. Operation Faden. In this case, the muscles are not cut off, but are sutured directly to the sclera with non-absorbable threads.
4. Resection (removal) of part of the muscle. The operation serves to shorten it and enhance its effect.
5. Formation of a fold within a muscle or between a muscle and tendon. The effect is similar to the previous operation.

Principles of surgery

The most optimal is the following scheme:

• Step-by-step correction. First, the operation is performed on one eye, and after 3-6 months - on the other.
• Calculation of muscle shortening or lengthening is carried out in accordance with standard schemes.
• Shortening and lengthening should occur evenly on both sides, i.e., for example, when the size of the muscles on the right is reduced, on the left they increase by the same amount.
• It is advisable to maintain the connection between the muscle and the eyeball.
• In cases of severe strabismus, surgery on more than two muscles is not recommended.

Details of the procedure are determined by the surgeon. With a slight mowing angle, it is possible to correct two eyes at once.

It is worth noting that the approach of Western doctors is somewhat different. Israeli and German specialists approach correction more radically, which makes it possible to correct vision immediately and in one visit. Also abroad, operations to eliminate strabismus are performed before the age of one year. This, according to doctors, helps avoid vision loss and the appearance of amblyopia (a symptom of a “lazy” eye).

Progress of the operation

Surgery is performed under general anesthesia in children and local anesthesia in adults. Sometimes before and after surgery, apparatus exercises (orthoptic exercises on the synoptophore) are indicated. They last 1-2 weeks and are designed to “teach” the eye to see correctly. Sometimes preparation lasts much longer – up to six months. During this period, the doctor recommends taking turns closing and opening the right and left eyes. This is necessary for the formation of stable nerve connections in the brain.

After the onset of anesthesia, the eye is fixed, the eyelids are retracted using special spacers. There are at least two people in the office - a doctor and nurse. A sterile oilcloth with a slit for the eye is placed on the person’s face. The doctor cuts the sclera, conjunctiva and opens access to the muscles. The nurse periodically moistens the eye and holds it in the correct position.

The muscle is pulled out through the incision. The nurse periodically dabs the eye with a swab so that blood does not interfere with the operation. The doctor makes an incision or suturing of the muscle, taking measurements and monitoring the accuracy of his actions. After this, stitches are applied. In some cases, the operation is performed under a microscope.

At the end of the operation, a bandage may be applied to the eye, which is removed the next day. The patient remains on a drip for some time. Once the anesthesia wears off, he can leave the operating room. As a rule, hospitalization is not required, and the patient returns home on the day of the procedure.

Postoperative period

After the end of the anesthesia, the eye may hurt, its movements will lead to increased discomfort. It will appear reddened and there may be temporary slight blurring of vision. Adults sometimes experience double vision.

Recovery lasts up to 4 weeks. In children it occurs faster. During this period, it is necessary to periodically visit an ophthalmologist, instill prescribed medications, and perform special exercises. The doctor will give a recommendation for wearing glasses. He usually advises covering the healthy eye in order to quickly “activate” the operated one.

Possible complications

The most serious consequence of the operation is accidental damage to the vagus nerve. It is responsible for the functioning of the muscles of the heart, gastrointestinal tract and lungs. In rare cases, disruption of the innervation can lead to death.

The most common complication is overcorrection - excessive suturing or lengthening of the muscle. It can occur as a result of an error in calculations, a surgeon’s error, or due to the growth of the patient and the natural increase in size of the eye. The optimal prevention of the occurrence of such a symptom is the application of adjustable sutures, not cutting, but suturing the muscle folds. This makes it easy to correct the situation in a minimally invasive way.

Sometimes after resection or cutting off of a muscle and its subsequent suturing, rough scars form. They deprive it of elasticity and mobility. This occurs due to the fact that muscle tissue is partially replaced by fibrous tissue. To prevent such complications, specialists are currently actively developing new methods of accessing the muscle, alternative methods of surgical treatment to reduce the area of ​​the truncated area.

Defects of the eyeball can form as a result of careless actions of the surgeon. They are usually cosmetic in nature and do not affect visual acuity.

Relapse of the disease is the re-development of strabismus. This complication often occurs if the patient neglects the doctor’s recommendations, refuses to wear glasses or perform special exercises. In childhood, relapse can occur with a sharp increase in eye strain, for example, when a child begins to attend school.

Cost of the operation

When contacting the government medical institution Squint correction surgery is performed free of charge for both adults and children with a compulsory medical insurance policy. Treatment is carried out inpatiently. Some private clinics also work with compulsory health insurance policies.

Children under 18 years of age and those with severe visual impairments may require an accompanying person. His stay in the hospital is not always provided for or may require additional payment.

The average cost of strabismus treatment in private clinics in Russia is 20,000 rubles. The price is influenced by the technology used, the complexity of the operation, and the reputation of the clinic or specific surgeon.

If the choice falls on correcting strabismus in an Israeli or German clinic, you will have to prepare from 7,000 euros. When using an intermediary company, the price may increase 2-3 times.

The necessity and justification of general anesthesia is no longer in doubt. In the surgical sector of medicine, general anesthesia is as necessary as air. In addition, this method is used by dentists in particularly unpleasant situations, gynecologists (for some pathologies), as well as doctors of many other specialties.

General anesthesia is definitely necessary, but do not forget that loss of consciousness through drug stunning of the nervous system is a critical situation for the body, which has a number of side effects and complications.

That is why there is a very difficult medical specialty– anesthesiologist.

Before administering anesthesia, the doctor explains in detail the main risks and adverse reactions. As a rule, the patient is introduced to typical complications, as well as individual risks associated with age, pathologies of cardio-vascular system, oncological pathology and so on.

Nausea after anesthesia

Nausea is the most common side effect

Most common side effect after anesthesia. Occurs in every third case. Of course, with local (regional) anesthesia this complication is much less common.

There are some general principles to reduce the likelihood of nausea after anesthesia:

• Don’t rush to get up after surgery, much less run somewhere. Your body does not know that you are an important busy person, it only understands that it was first stunned with chemicals, and now for some reason they are shaking it. As a result, you may vomit at the most inopportune moment;
• Do not drink or eat for 3 hours after surgery;
• If you are concerned strong pain(the anesthetic is titrated incorrectly, for example), then there is no need to endure it - tell the nurse or doctor, because may vomit from pain;
• If nausea occurs, try to breathe deeply and slowly. Saturating tissues with oxygen reduces the risk of nausea.

Pain when swallowing or speaking and dry mouth

Pain when swallowing may occur after endotracheal anesthesia

After endotracheal anesthesia (the most popular type of general anesthesia), you may experience a sore throat, pain when swallowing or while talking. These are the consequences of not entirely successful intubation. This is usually associated with anatomical features the patient, less often - with the negligence of the anesthesiologist. This kind of pain goes away within a few hours after anesthesia. Sometimes it takes 2-3 days for this side effect to disappear.

If after surgery the sore throat does not go away after 2 days, contact your doctor. Most likely, the tube injured the tracheal mucosa.

Headache after general anesthesia

Headache after anesthesia is more common in women

This complication occurs more often in women, especially in those prone to migraines and headaches in general. Medicines, stress on the body from the very surgical manipulation, the patient’s fears – there are plenty of reasons for vascular spasm and headaches.

This type of headache goes away within 2-3 hours after the procedure.

On the other hand, headache is a typical complication of spinal and epidural anesthesia, which the doctor should warn the patient about in such cases.

Dizziness can be due to a transient decrease in blood pressure, and also as a consequence of dehydration. Patients may also experience weakness, even to the point of fainting.

Stupor (impaired perception) after surgery

Confusion or stupor is a common side effect in older adults

Often found in elderly patients. After anesthesia, the nervous system experiences some difficulties in cleansing cells and restoring cognitive functions: memory temporarily deteriorates, and deviant behavior may occur. Fortunately, all these problems are temporary and gradually disappear (up to 2 weeks).

The causes of this kind of complications are associated both with the metabolic characteristics of the elderly and with the psychological trauma from the fact of the operation. An increased burden is also created by communicating with strangers in an unusual (frightening) environment.

At elective surgery In an elderly person, you can reduce the severity of this complication as follows:

• Try (if the disease allows) to lead an active lifestyle before surgery;
• If it is possible to carry out the manipulation under local anesthesia, do so;
• If you live with your family, try to agree with your doctor about the maximum quick return home after surgery;
• Check if you took the medications prescribed to you (for hypertension, for example), reading glasses and books (magazines, checkers, etc.) to the hospital;
• Do not drink alcohol before or after anesthesia.

Body tremors after surgery

Many patients experience severe tremors after emerging from anesthesia. This condition does not pose a danger to health, but it is quite annoying for the patient. Paroxysms of this kind last no more than half an hour. The type of anesthesia in this case does not matter - the reason is the cooling of the tissues during the operation (the individual characteristics of microcirculation, diabetes, and the patient play a role).

The only thing that can be done to prevent this condition is not to freeze before surgery (take warm clothes to the hospital in the cold season).

In some cases, the doctor is not informed about the patient’s allergic reactions. Sometimes the patient himself does not know that he has an allergy. For this reason, skin reactions may develop, manifested by itching, which should be reported to your doctor immediately. Often this kind of excess is caused by morphine and some other drugs used for anesthesia.

Itchy skin after anesthesia may be the result of an allergic reaction

Spinal pain after surgery

At spinal anesthesia pain can be caused by a traumatic factor, so if you experience pain in the lumbar or any other part of the spine, tell your doctor. This is especially important in cases where back pain is combined with paresis or plegia of the limb (limited mobility).

The above case is a very rare complication. Most often, the back hurts because a person has been lying on a fairly hard surface of the operating table for some time, which, in combination with osteochondrosis, gives pain.

Lower back pain and other muscle pain are the result of using Ditilin

Muscle pain after anesthesia

Caused by the use of the drug Ditilin, which is actively used in urgent surgery (especially when the patient is not ready for surgery - a full stomach, etc.). All muscles hurt, especially the neck, shoulders, and abs.

The duration of “ditilin” pain does not exceed 3 days after anesthesia.

All subsequent complications are, fortunately, quite rare, but the doctor must take into account their possibility and be prepared for them.

Injury to lips, tongue or teeth during surgery

Injury to the tongue or teeth is a consequence not of anesthesia, but of its administration

These are, in fact, not the consequences of the anesthesia itself, but mechanical damage during its administration. Teeth are damaged, on average, in two out of 100,000 patients (carious, as a rule). Before general anesthesia, it is advisable to treat caries and stomatitis.

The tongue and lips are slightly damaged in one out of 20 patients; you need to be mentally prepared for this. All defects disappear without a trace within a week after anesthesia.

Postoperative pulmonary infection

Postoperative - a consequence of an infection

The infection enters the lungs due to tracheal intubation, trauma and infection of the mucous membrane, or due to an unsterile tube. In addition, the cause may be either the patient’s atypical anatomy of the respiratory tract or an existing chronic disease. respiratory system(chronic).

To reduce the risk of postoperative pneumonia, the following is recommended:

• We quit smoking one and a half months before the planned surgery;
• Bronchitis, tracheitis, laryngitis and sinusitis (if any) must be treated before endotracheal anesthesia;
• If it hurts to breathe after surgery, tell your doctor right away. Insufficient breathing increases the risk of infection, and hospital infection– the most “evil”.

Waking up during an operation

It happens extremely rarely and is eliminated by anesthesiologists almost instantly. This kind of situation occasionally occurs with drug addicts, as well as people who constantly take powerful analgesics (cancer patients, for example).

The brain, getting used to the effect on certain centers, in this case needs a higher dose of analgesic.

If (purely hypothetically) you constantly take sleeping pills, strong painkillers, or are dependent on any chemical substances, it is in your best interests to tell the anesthesiologist about this.

There are three varieties of this condition:

• The patient wakes up during surgery and tries to move. Doctors react instantly by increasing the dose of analgesic substances. The patient does not have time to really wake up or feel pain;
• The patient wakes up, does not feel pain, and cannot move. A rather surreal situation, but the patient does not experience any discomfort (except psychological);
• The patient wakes up, cannot move, and feels pain. In this case, serious mental trauma may remain.

Nerve damage during spinal or epidural anesthesia

They are extremely rare. As a rule, such damage is temporary and disappears within a month or a month and a half maximum.

One in 50,000 patients will experience paralysis of one or both limbs after spinal or epidural anesthesia.

This condition occurs due to the following factors:

• The nerve was injured by the anesthesiologist himself during the puncture;
• The nerve was damaged by the surgeon during the relevant operation;
• The patient was placed in an incorrect position on the operating table, which led to nerve compression;
• As a result of the operation, tissue edema developed, compressing the nerve;
• The patient had severe diabetes or atherosclerosis, which significantly increases the likelihood of such a situation.

I would like to emphasize once again that the indications for anesthesia of this kind are vital, and the probability of disability is only 0.0002%.

Anaphylactic shock during surgery

It rarely develops, it can happen to anything. If you carefully study the instructions for any drug (not a dietary supplement), then there is definitely a complication - individual intolerance (allergic reactions to components, etc.). If such a situation develops during anesthesia (1 case in 15,000), the anesthesiologist copes with the situation in 95% of cases.

The remaining 5% of 0.00006% of patients die.

In short, a vanishingly small number of patients die from anaphylactic shock during anesthesia; there is no need to worry about this.

Photo gallery: rare complications during anesthesia

Dry cornea is a cause of damage when the patient awakens

Damage to the eyeball

Actually, no one touches the patient’s eyes during the operation; it’s just that some patients, due to certain physiological nuances, do not completely close their eyelids. The cornea dries out, and the eyelid itself can “stick” to it from the inside. When a person wakes up and tries to open his eye, the cornea is damaged. This manifests itself in the form of a dark dot on the damaged eye; over time, the condition goes away without additional therapeutic manipulations.

All taken together, the complications that anesthesia can cause are incomparable to the health benefits (including the ability to live in general) of the patient. Try to take into account the risk factors described above for postoperative complications and inform your doctor about them in a timely manner.

Risk is an integral part of all our lives. Many of the things we do in our Everyday life, are associated with a certain risk to our health - this includes driving a car, swimming in a pond, and even eating certain types of food.

Many used in modern medicine therapeutic techniques, designed by definition to improve the health status of patients, can themselves cause the development of serious complications, as paradoxical as this may sound. Surgical interventions are no exception (which sometimes cause serious surgical complications), and the anesthesia performed, the role of which we want to talk about in this article.

Anesthesia is designed to protect your body from surgical trauma. Anesthesia is not so much pain relief as ensuring the safety of your life during surgery. Despite the fact that anesthesia, as such, is a great benefit and a positive component of the operation, at the same time, it itself can cause the development of serious reactions and complications.

Your anesthesiologist will be able to tell you in more detail what risks the planned operation and anesthesia pose to you. Below we will tell you about the most common reactions and complications that can be the consequences of anesthesia and anesthesia.

First, it should be said that all reactions and complications according to the frequency of development are usually divided into five gradations:

For greater simplicity and better understanding, we have presented to you All possible complications anesthesia and effects of anesthesia in the form of three blocks:

1 Very often, as well as common complications of anesthesia, consequences of anesthesia:

1.1 Nausea

1.2 Sore throat

1.4 Dizziness and lightheadedness

1.5 Headache

1.7 Pain in the back and lower back

1.8 Muscle pain

1.9 Confusion

2 Uncommon consequences of anesthesia, complications of anesthesia:

2.1 Postoperative pulmonary infection

2.2 Injury to teeth, lips, tongue

2.3 Awakening during general anesthesia

3 Rare and very rare complications of anesthesia and consequences of anesthesia:

3.1 Nerve damage associated with general anesthesia

3.2 Nerve injury associated with regional anesthesia

3.3 Serious allergic reaction (anaphylaxis)

3.4 Eye damage during general anesthesia

3.5 Death or brain damage

Very common and common adverse reactions and complications of anesthesia (consequences of anesthesia)

• Nausea

This is a very common consequence of anesthesia, occurring in approximately 30% of cases. Nausea is more common with general than with regional anesthesia. Here are some tips to help reduce your risk of nausea:

During the first hours after surgery, you should not be active - sitting down and getting out of bed;

Avoid drinking water and food immediately after surgery;

Good pain relief is also important as severe pain can cause nausea, so if you experience pain, tell your healthcare team;

Deep breathing and slowly inhaling air can help reduce the feeling of nausea.

• A sore throat

Its severity can vary from discomfort to severe constant pain disturbing when talking or swallowing. You may also experience dry mouth. These symptoms may subside within a few hours after surgery, but may persist for two or more days. If the above symptoms do not go away within two days after surgery, contact your doctor. A sore throat is only a consequence, not a complication of anesthesia.

• Shiver

Trembling, which is another consequence of anesthesia, poses a certain problem for patients, as it causes them great discomfort, although most often it does not pose any danger to the body and lasts about 20-30 minutes. Trembling can occur either after general anesthesia or as a complication of epidural or spinal anesthesia. You may be able to reduce your risk of shivering somewhat by keeping your body warm before surgery. You need to take care of warm things in advance. Remember that the hospital may be cooler than your home.

• Dizziness and lightheadedness

The residual effect of anesthetics may manifest itself in the form of a slight decrease in blood pressure, in addition, dehydration, which is not so uncommon after surgery, can lead to the same effect. A decrease in pressure can cause dizziness, weakness, and faintness.

• Headache

There are many reasons that can cause a headache. These are medications used for anesthesia, the operation itself, dehydration and simply unnecessary anxiety for the patient. Most often, the headache goes away a few hours after anesthesia on its own or after taking painkillers. Severe headache can be a complication of both spinal anesthesia and epidural analgesia. The features of its treatment are described in detail in the article “Headache after spinal anesthesia.”

Itching is usually a side reaction to anesthesia medications (particularly morphine), but itching can also be a manifestation of an allergic reaction, so if it occurs, be sure to tell your doctor.

• Back and lower back pain

During surgery, the patient remains in one constant position on a hard operating table for quite a long time, which can lead to “tired” back and, ultimately, to lower back pain after surgery.

• Muscle pain

Most often, muscle pain after anesthesia occurs in young males, most often their occurrence is associated with the use of a drug called ditilin during anesthesia, usually used in emergency surgery, as well as situations when the patient’s stomach is not free from food. Muscle pain is a consequence of anesthesia (general anesthesia), it is symmetrical, most often localized in the neck, shoulders, upper abdomen and lasts approximately 2-3 days after surgery.

• Confusion

Some patients, most often elderly, experience confusion after surgery and anesthesia. Their memory may deteriorate, and their behavior may differ from their usual state. This can be very worrying for you, your family, friends and loved ones. However, all these phenomena should disappear along with recovery from the operation.

The following recommendations can reduce the likelihood of postoperative impairment of consciousness:

Before hospitalization, try to be as healthy as possible, eat healthy foods, do exercise;

Talk to your anesthesiologist about the possibility of performing the operation under regional anesthesia;

If your operation is not large in scope and you do not live alone at home, then discuss with your attending surgeon the possibility of returning home as early as possible after the operation;

Make sure you remember to take your contact lenses and hearing aids to the hospital;

Unless your doctor says otherwise, continue to take your usual home medications in the hospital;

If you drink alcohol, you should consult with a narcologist about how to safely reduce and then completely stop taking it. In the hospital, you should also tell your doctors how much alcohol you drink.

Uncommon consequences of anesthesia, adverse reactions and complications of anesthesia

• Postoperative pulmonary infection

Pulmonary infection (bronchitis, pneumonia) is most often a consequence of general anesthesia (anesthesia). A few simple measures will significantly reduce the risk of this complication:

If you are a smoker, you should quit smoking approximately 6 weeks before surgery;

If you have a chronic pulmonary disease, it should be treated as much as possible before your planned anesthesia. To do this, even before hospitalization, seek medical help from your primary care physician or pulmonologist;

Good pain relief after surgery is the key to good breathing and coughing ability, and, therefore, an important link in reducing the risk of pulmonary infection. Talk to your anesthesiologist about postoperative epidural pain relief if you are having major surgery on the chest or abdomen.

• Injury to teeth, lips, tongue

General anesthesia poses some risk of dental damage, which occurs in approximately 1 in 45,000 anesthesia experiences. Serious damage to the tongue is quite rare. But minor injuries to the lips or tongue occur quite often - in approximately 5% of cases of general anesthesia.

If your teeth or gums are in poor condition, then warn possible problems A pre-operative visit to the dentist will help you with your teeth. If you know that during previous anesthesia there were difficulties with inserting the breathing tube or that your teeth were damaged, be sure to provide this information to your anesthesiologist.

• Waking up during anesthesia

When the patient is given general anesthesia, he is unconscious. Awakening during anesthesia is a situation when, during an operation, the patient regains consciousness, and after anesthesia he can remember some episodes of the operation itself. Fortunately, this very unpleasant anesthesia complication occurs in real life rarely.

Rare and very rare adverse reactions and complications of anesthesia (consequences of anesthesia)

• Nerve damage as a complication of general anesthesia

This type of complication is characterized by a feeling of numbness, tingling or pain. There may also be a disturbance in the sensation of heat or cold. There may also be a feeling of weakness in the limb or paralysis. Depending on the extent of the lesion, all these manifestations can be disturbing in any small area of ​​the body or the entire limb. Usually, all complaints, depending on the initial severity of symptoms, disappear after a few days or months. Full recovery can sometimes take up to a year. The most common injuries occur to the ulnar nerve in the elbow area, as well as the peroneal nerve in the knee area.

• Nerve injury, which is a complication of epidural anesthesia, as well as a complication of spinal anesthesia

These complications are rare and usually temporary damage that resolves after a few weeks to months. Cases of complete immobilization (paralysis) of one or two limbs are very rare (approximately 1 case in 50,000).

If signs of nerve injury appear after surgery, this does not mean that the cause was epidural or spinal anesthesia. Below are other equally common causes that can cause nerve injury:

The nerve can be injured by the surgeon (unfortunately, during some operations this is sometimes difficult and impossible to avoid);

The position in which you were placed on the operating table may put pressure or tension on the nerve, causing it to become damaged;

The use of tourniquets by the surgeon to reduce the amount of blood loss during surgery puts pressure on the nerve, also contributing to its damage;

In addition, postoperative swelling (in the area of ​​surgery) may be the cause of nerve compression;

The presence of concomitant chronic diseases such as diabetes mellitus or vascular atherosclerosis significantly increases the risk of nerve damage during anesthesia

• Severe allergic reaction (anaphylaxis)

During anesthesia, as well as throughout your entire stay in the hospital, you will constantly receive a large amount of medications necessary for your speedy recovery. All of these medications can cause a very severe allergic reaction - anaphylaxis. The incidence of its development is approximately 1 case in 15,000 anesthesias. As a rule, an anesthesiologist successfully diagnoses and treats this serious complication, but statistically one in twenty such serious reactions can lead to death.

• Eye damage during general anesthesia

This is an uncommon or rare complication of anesthesia. The most common type of eye injury during and after general anesthesia is corneal injury (approximately 1 in 2000 anesthesia events). This pathology does not affect visual acuity, but can lead to the appearance of a dark or blurry dot on the affected eye. Most often, corneal injury occurs due to the fact that during anesthesia the patient's eyelids do not always close completely. As a result, the cornea becomes dry and the eyelid “sticks” to it from the inside. Further, when the eyes are opened, damage to the cornea occurs.

Eye damage leading to loss of vision is statistically extremely rare.

• Death or brain damage

If the patient is relatively healthy and is undergoing non-emergency surgery, then the risk of death is very small and is about 1 case per 100,000 general anesthesias. The risk increases if the patient is elderly, if the operation is emergency or extensive, if there are pre-existing health problems (especially heart or lung disease), and if the patient's general condition before surgery is severe. The risk of stroke resulting in brain damage increases in older people, in patients who have previously had a stroke, and also in cases where surgery is performed on the brain, neck, carotid arteries or heart.

The necessity and justification of general anesthesia is no longer in doubt. In the surgical sector of medicine, general anesthesia is as necessary as air. In addition, this method is used by dentists in particularly unpleasant situations, gynecologists (for some pathologies), as well as doctors of many other specialties.

General anesthesia is definitely necessary, but do not forget that loss of consciousness through drug stunning of the nervous system is a critical situation for the body, which has a number of side effects and complications.

That is why there is a very difficult medical specialty - anesthesiologist.

Before administering anesthesia, the doctor talks in detail about the main risks and side effects. As a rule, the patient is introduced to typical complications, as well as individual risks associated with age, pathologies of the cardiovascular system, oncological pathology, etc.

Nausea after anesthesia

Nausea is the most common side effect

The most common side effect after anesthesia. Occurs in every third case. Of course, with local (regional) anesthesia this complication is much less common.

There are some general principles to help reduce the likelihood of nausea after anesthesia:

• Don’t rush to get up after surgery, much less run somewhere. Your body does not know that you are an important busy person, it only understands that it was first stunned with chemicals, and now for some reason they are shaking it. As a result, you may vomit at the most inopportune moment;
• Do not drink or eat for 3 hours after surgery;
• If you are worried about severe pain (the anesthetic was titrated incorrectly, for example), then you should not endure it - tell the nurse or doctor, because may vomit from pain;
• If nausea occurs, try to breathe deeply and slowly. Saturating tissues with oxygen reduces the risk of nausea.

Pain when swallowing or speaking and dry mouth

Pain when swallowing may occur after endotracheal anesthesia

After endotracheal anesthesia (the most popular type of general anesthesia), you may experience a sore throat, pain when swallowing or while talking. These are the consequences of not entirely successful intubation. This is usually associated with the anatomical characteristics of the patient, and less often with the negligence of the anesthesiologist. This kind of pain goes away within a few hours after anesthesia. Sometimes it takes 2-3 days for this side effect to disappear.

If after surgery the sore throat does not go away after 2 days, contact your doctor. Most likely, the tube injured the tracheal mucosa.

Headache after general anesthesia

Headache after anesthesia is more common in women

This complication occurs more often in women, especially in those prone to migraines and headaches in general. Medicines, stress on the body from the surgical procedure itself, the patient’s fears – there are plenty of reasons for vascular spasm and headaches.

This type of headache goes away within 2-3 hours after the procedure.

On the other hand, headache is a typical complication of spinal and epidural anesthesia, which the doctor should warn the patient about in such cases.

Dizziness can be due to a transient decrease in blood pressure, and also as a consequence of dehydration. Patients may also experience weakness, even to the point of fainting.

Stupor (impaired perception) after surgery

Confusion or stupor is a common side effect in older adults

Often found in elderly patients. After anesthesia, the nervous system experiences some difficulties in cleansing cells and restoring cognitive functions: memory temporarily deteriorates, and deviant behavior may occur. Fortunately, all these problems are temporary and gradually disappear (up to 2 weeks).

The causes of this kind of complications are associated both with the metabolic characteristics of the elderly and with the psychological trauma from the fact of the operation. An increased burden is also created by communicating with strangers in an unusual (frightening) environment.

During elective surgery in an elderly person, the severity of this complication can be reduced as follows:

• Try (if the disease allows) to lead an active lifestyle before surgery;
• If it is possible to carry out the manipulation under local anesthesia, do so;
• If you live with your family, try to agree with your doctor about returning home as quickly as possible after surgery;
• Check if you took the medications prescribed to you (for hypertension, for example), reading glasses and books (magazines, checkers, etc.) to the hospital;
• Do not drink alcohol before or after anesthesia.

Body tremors after surgery

Many patients experience severe tremors after emerging from anesthesia. This condition does not pose a danger to health, but it is quite annoying for the patient. Paroxysms of this kind last no more than half an hour. The type of anesthesia in this case does not matter - the reason is the cooling of the tissues during the operation (the individual characteristics of microcirculation, diabetes, and atherosclerosis in the patient play a role).

The only thing that can be done to prevent this condition is not to freeze before surgery (take warm clothes to the hospital in the cold season).

Itchy skin after anesthesia

In some cases, the doctor is not informed about the patient’s allergic reactions. Sometimes the patient himself does not know that he has an allergy. For this reason, skin reactions may develop, manifested by itching, which should be reported to your doctor immediately. Often this kind of excess is caused by morphine and some other drugs used for anesthesia.

Itchy skin after anesthesia may be the result of an allergic reaction

Spinal pain after surgery

During spinal anesthesia, pain can be caused by a traumatic factor, so if you experience pain in the lumbar or any other part of the spine, tell your doctor. This is especially important in cases where back pain is combined with paresis or plegia of the limb (limited mobility).

The above case is a very rare complication. Most often, the back hurts because a person has been lying on a fairly hard surface of the operating table for some time, which, in combination with osteochondrosis, gives pain.

Lower back pain and other muscle pain are the result of using Ditilin

Muscle pain after anesthesia

Caused by the use of the drug Ditilin, which is actively used in urgent surgery (especially when the patient is not ready for surgery - a full stomach, etc.). All muscles hurt, especially the neck, shoulders, and abs.

The duration of “ditilin” pain does not exceed 3 days after anesthesia.

All subsequent complications are, fortunately, quite rare, but the doctor must take into account their possibility and be prepared for them.

Injury to lips, tongue or teeth during surgery

Injury to the tongue or teeth is a consequence not of anesthesia, but of its administration

These are, in fact, not the consequences of the anesthesia itself, but mechanical damage during its administration. Teeth are damaged, on average, in two out of 100,000 patients (carious, as a rule). Before general anesthesia, it is advisable to treat caries and stomatitis.

The tongue and lips are slightly damaged in one out of 20 patients; you need to be mentally prepared for this. All defects disappear without a trace within a week after anesthesia.

Postoperative pulmonary infection

Postoperative pneumonia is a consequence of an infection

The infection enters the lungs due to tracheal intubation, trauma and infection of the mucous membrane, or due to an unsterile tube. In addition, the cause may be either the patient’s atypical anatomy of the respiratory tract, or an existing chronic disease of the respiratory system (chronic bronchitis).

To reduce the risk of postoperative pneumonia, the following is recommended:

• We quit smoking one and a half months before the planned surgery;
• Bronchitis, tracheitis, laryngitis and sinusitis (if any) must be treated before endotracheal anesthesia;
• If it hurts to breathe after surgery, tell your doctor right away. Insufficiently active breathing increases the risk of infection, and hospital infection is the most “evil” one.

Waking up during an operation

It happens extremely rarely and is eliminated by anesthesiologists almost instantly. This kind of situation occasionally occurs with drug addicts, as well as people who constantly take powerful analgesics (cancer patients, for example).

The brain, getting used to the effect on certain centers, in this case needs a higher dose of analgesic.

If (purely hypothetically) you constantly take sleeping pills, strong painkillers, or are dependent on any chemical substances, it is in your best interests to tell the anesthesiologist about this.

There are three varieties of this condition:

• The patient wakes up during surgery and tries to move. Doctors react instantly by increasing the dose of analgesic substances. The patient does not have time to really wake up or feel pain;
• The patient wakes up, does not feel pain, and cannot move. A rather surreal situation, but the patient does not experience any discomfort (except psychological);
• The patient wakes up, cannot move, and feels pain. In this case, serious mental trauma may remain.

Nerve damage during spinal or epidural anesthesia

They are extremely rare. As a rule, such damage is temporary and disappears within a month or a month and a half maximum.

One in 50,000 patients will experience paralysis of one or both limbs after spinal or epidural anesthesia.

This condition occurs due to the following factors:

• The nerve was injured by the anesthesiologist himself during the puncture;
• The nerve was damaged by the surgeon during the relevant operation;
• The patient was placed in an incorrect position on the operating table, which led to nerve compression;
• As a result of the operation, tissue edema developed, compressing the nerve;
• The patient had severe diabetes or atherosclerosis, which significantly increases the likelihood of such a situation.

I would like to emphasize once again that the indications for anesthesia of this kind are vital, and the probability of disability is only 0.0002%.

Anaphylactic shock during surgery

It rarely develops, it can happen to anything. If you carefully study the instructions for any drug (not a dietary supplement), then there is definitely a complication - individual intolerance (allergic reactions to components, etc.). If such a situation develops during anesthesia (1 case in 15,000), the anesthesiologist copes with the situation in 95% of cases.

The remaining 5% of 0.00006% of patients die.

In short, a vanishingly small number of patients die from anaphylactic shock during anesthesia; there is no need to worry about this.

Photo gallery: rare complications during anesthesia

Dry cornea is a cause of damage when the patient awakens

Damage to the eyeball

Actually, no one touches the patient’s eyes during the operation; it’s just that some patients, due to certain physiological nuances, do not completely close their eyelids. The cornea dries out, and the eyelid itself can “stick” to it from the inside. When a person wakes up and tries to open his eye, the cornea is damaged. This manifests itself in the form of a dark dot on the damaged eye; over time, the condition goes away without additional therapeutic manipulations.

All taken together, the complications that anesthesia can cause are incomparable to the health benefits (including the ability to live in general) of the patient. Try to take into account the risk factors described above for postoperative complications and inform your doctor about them in a timely manner.

General practitioner at a city clinic. Eight years ago I graduated from Tver State Medical University with honors. I decided not to stop there and am currently specializing in cosmetology and massage courses. Rate this article:

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After general anesthesia, absolutely everyone feels bad, although no ethers are used now.

It is well known that after their use, the liver stopped working in many patients.

Is general anesthesia harmful or is it a myth? Does anesthesia affect human life expectancy and health?

Modern drugs for anesthesia are slightly toxic to human organs.

If the dose is calculated correctly for you, the drug is administered correctly, there is nothing to be afraid of.

But we are afraid of anesthesia and pain, although we understand the inevitability of the operation and its necessity.

Now there is a lot of new things: equipment, drugs, a lot of new technologies, but we are still afraid, perhaps we don’t know what anesthesia is? What to expect from him?

Anesthesia implies safety during and after surgery.

The patient’s condition after general anesthesia, quality in a good clinic:

• No pain during treatment.
• No nausea or vomiting after surgery.
• Absence of chills, trembling (sometimes it is impossible to do without these symptoms after surgery).
• During operations, constant monitoring of breathing and blood circulation is carried out.
• Monitoring electrical activity brain, muscle conduction control, temperature regime.

After the operation, the patient is given anesthesia; if this is not enough, the patients inject themselves by pressing a button.

For this purpose, special devices have appeared that the patient carries with him constantly.

Doctors then monitor how many times the patient presses the button, using these calculations to determine the degree of recovery of the patient.

Thanks to this, the time after surgery passes comfortably.

Before taking general anesthesia, consider:

• Your weight or body mass index.
• Medical history, tests, permission from specialists for anesthesia are studied.
• Patient's age.
• Current medications taken and allergic reactions to them.
• The patient's consumption of alcohol or drugs.
• Dental examination, as well as the oral cavity and respiratory tract.

General anesthesia, what is it:

General anesthesia, a state of coma, sleep in which the patient does not feel pain. He is not in pain, there are no reactions. The man seems unconscious.

General anesthesia is administered intravenously or inhaled.

Medicines are administered by an anesthesiologist, a specialist who monitors the patient's vital signs and breathing during surgery.

There are four stages:

Induction or first stage:

Characterized by the onset of drug administration and loss of sensitivity (consciousness).

Excitation stage – second stage:

There is delusional, excited activity. Heartbeats and breathing are erratic.

Nausea and dilated pupils may occur.

There is a danger of suffocation. Modern drugs limit the time for the two stages described above.

Surgical anesthesia or third stage:

When it occurs, all muscles relax and breathing is suppressed. Eye movement slows and then stops. The patient is ready for surgery.

Overdose stage, if your anesthesia dose was calculated incorrectly:

Leads to cardiovascular and respiratory failure.

As you understand, the fourth stage is an exception to the rule, but it sometimes happens, as everywhere and always.

Why do they do general anesthesia, and not anesthesia of only the necessary area of ​​the body?

Under what circumstances is it prescribed?

• The operation takes a long time.
• Risk of major blood loss.
• According to the patient's well-being.

Modern surgical treatment is an absolutely safe intervention.

Immediately after anesthesia you may feel:

• Difficulty passing urine.
• Bruising, soreness on the arm due to the IV during surgery.
• Constant nausea, possible vomiting.
• Trembling and feeling cold, you will shake, and at first it will be difficult to warm up.
• Sore throat (due to the presence of a breathing tube during surgery).
• You will not feel pain; nurses will constantly administer pain relief.

But there are groups at greater risk for consequences:

Elderly people undergoing long-term operations are at risk of serious consequences.

After anesthesia, they can suffer a heart attack, amnesia (memory loss), stroke and even pneumonia.

Of course, it’s good that now you can have surgery and recover, if not for the consequences after it. They are.

The consequences are early and appear later.

Consequences after general anesthesia:

Early consequences are immediately visible: the person does not recover from the state of anesthesia, and a cerebral coma occurs.

The consequences appear after a few days or weeks:

• Severe headache that is difficult to relieve with analgesics. Often you have to remove them with narcotic drugs.
• Sleep apnea - people stop breathing for a short period of time while sleeping.
• Blood pressure rises.
• Sudden dizziness that can last up to a day.
• arise panic attacks, fear that interferes with normal life. A person does not understand where this comes from or what to do.
• Cramps in the legs and calves, causing incredible suffering to the patient due to their frequent occurrence.
• The heart suffers, malfunctions appear, the pulse is frequent with high blood pressure.
• The kidneys and liver, the cleansing organs of our body, suffer. Whatever the drugs for anesthesia, in order for a person not to feel anything, an incredibly huge dose of them is needed. Naturally, to cleanse everything you need healthy organs.
• Sometimes alcoholism develops.
• Burning legs, arms, body.

Help yourself after surgery:

It’s very good to take courses:

• Piracetam, Cavinton (improves blood circulation and brain nutrition). Memory will be restored faster and headaches will go away.
• Take another ECG (electrocardiogram) to see what’s wrong with your heart after the operation.
• Donate blood, go to a therapist with the results obtained. Don't waste time.
• Avoid anesthesia at all times and everywhere. Treat your teeth under local anesthesia.

Sometimes life and health force us to take extreme measures in recovery methods - to have surgery, undergo anesthesia and crawl out after general anesthesia, get rid of the consequences after general anesthesia.

This is life, everything happens in it. Fewer such episodes in your life. Health and longevity!

I always look forward to seeing you on my website.

Watch the video, allergies and anesthesia:

The influence of anesthesia on the human body and its consequences are always taken into account and assessed in conjunction with the risks of refusing surgical intervention. If it is possible to avoid surgery under anesthesia (there are other treatment methods), then it is quite clear that it is better to do it. But when refusing surgery can entail much more consequences than the effects of anesthetics, then there is only one way out in this situation. In any case, this issue is decided by the patient’s attending physician and anesthesiologist.

How does general anesthesia affect the human body?

Complete loss of consciousness and sensitivity is a method that is used only during the most difficult and lengthy operations, when it is impossible otherwise. How does anesthesia affect the human body: he loses consciousness, while all muscles completely relax, which makes it possible to perform the operation and avoid painful shock for the patient.

General anesthesia is divided into three types:

• Intramuscular.

Only the anesthesiologist decides which one will be used during the operation - he is guided by the patient’s illness picture. It is this doctor who selects a unique formula of drugs for each patient in order to put the patient to sleep, prevent pain shock from developing, and bring him out of sleep with minimal discomfort.

Almost every patient is concerned about how anesthesia affects the human body. Its main action is to “turn off” the brain. In medicine there is even special term characterizing the effect on the brain - post-operative cognitive dysfunction. It manifests itself with the following symptoms:

• Memory impairment.
• Deterioration in learning.
• Severe decrease in concentration.

These symptoms may last for up to a year after surgery. More details on how can be found in another article.

What is the effect of general anesthesia after surgery?

Given that the brain is the engine of our body, how can shutting it down affect other organs and senses?

Does anesthesia affect vision?

It doesn’t affect the eyes themselves, but the connection between the brain and what a person sees can be influenced. A person sees a picture, which is transmitted to our “processor”, and then processing occurs. Considering that the effect of general anesthesia on the human body comes down to “turning off the processor,” that is, the brain, it needs time to adjust its work after such a reboot. The first days after “switching off” there may be blurred vision, and sometimes even blindness. But usually such symptoms go away within a couple of weeks.

The effect of anesthesia on the nervous system

It is noted that more than 80% of patients become nervous after surgery. Even after several months, they may experience panic attacks.

The influence of anesthesia on the human psyche

Many patients may experience hallucinations after surgery. This does not last long, but is still common. This consequence often occurs after very long operations, when the brain has been in sleep mode for a very long time.

How it affects the kidneys, liver and heart

It's worth knowing that Negative consequences may also be for the kidneys, liver and heart. What is pain relief? These are the strongest chemicals. Therefore, there is a colossal effect on the kidneys, because they are the ones who must remove this drug from the body. In most cases, such general anesthesia is contraindicated in people with kidney failure.

Unfortunately, the answer to the question – does anesthesia affect the liver is also positive. This organ is a filter, which bears the brunt of the drugs. There are even special diets that are used after such anesthesia to minimize risks to the liver and quickly bring it back to normal.

Also, such manipulation is extremely poorly tolerated by the cardiovascular system. There may be strong surges in blood pressure and increased heart rate. More details on how can be found on our website.

How does anesthesia affect a child's body?

Before surgery, parents are always concerned about the question of whether anesthesia affects the health of their children. Unfortunately yes. Many studies have been conducted and they have confirmed that general anesthesia has a strong effect on the nervous system of children, and can also lead to the death of some cells in the brain. At a very early age, such manipulations can lead to developmental inhibition. Some children may lag behind their peers, but usually later catch up quickly.

Therefore, anything can be done to a child under general anesthesia only in the most critical cases. The more developed the child is, the older, the greater the chance that the operation will bring a minimum of negative consequences.

Prevention of complications

How anesthesia affects the body becomes clear after talking with an anesthesiologist. But the question is: is it possible to minimize the risks? There are a few simple rules:

• A week before surgery, avoid heavy foods. Eliminate everything fatty, smoked and fried.
• Avoid alcohol and smoking.
• Do not take any additional pain medications.
• Set yourself up for a positive outcome. The psychological mood of the patient is very important both for himself and for the doctor.
• After surgery, follow a special diet that is aimed at facilitating liver function and improving brain function. After all, there may be problems with memory after surgery. How, you can read here. Therefore, it is important to stimulate the brain.

These simple axioms will help you undergo surgery with the least risks and complications.

Conclusion

How anesthesia affects the human body is one of the most common questions asked by an anesthesiologist. Almost 90% are afraid not of the operation itself, but of general anesthesia. Yes, there are risks, but most often they are not commensurate with the risk of refusing surgery. The main effect is on the brain, liver and kidneys. Therefore, after the intervention, memory problems, panic attacks, nausea, and pain are possible. Anesthesia has a particularly detrimental effect on young children, so if possible they try not to undergo operations under general anesthesia.

It is worth knowing that anesthesia does not affect life expectancy in any way. Previously it was believed that it takes 5 years, but this is just a myth. In practice, such a hypothesis could not be proven.

I created this project to in simple language tell you about anesthesia and anesthesia. If you received an answer to your question and the site was useful to you, I will be glad to receive support; it will help further develop the project and compensate for the costs of its maintenance.