The purpose of combined anesthesia in surgical treatment for congenital cataracts in children is, in addition to providing adequate analgesia of the intra- and postoperative period, to decrease adverse reactions and functional-anatomical changes in eye structure. Objective: The goal of the study is to assess the effectiveness of blockade of the pterygopalatine fossa as a component of combined anesthesia in surgical treatment for congenital cataracts in children. Material and Methods: The study included 52 children operated for congenital cataracts. The patients were divided into 2 groups. In the first group (n=26) anesthesia was carried out on the base of sevoflurane in combination with a pterygopalatine blockade as a regional component, the distinctive feature of the second group (n=28) was the implementation of retrobulbar blockade. The effectiveness of the methods was evaluated by a comparative analysis of hemodynamic parameters, the index of the tension of the vegetative system, the level of cortisol in the blood plasma, the assessment of the intensity of pain on the verbal rating scale, as well as the surgeon’s definition of the degree of comfort of the operative intervention. Results and conclusion: The data received show that the use of blockade of the vascular nodule as a component of combined anesthesia in the surgery for congenital cataracts in children allows to provide adequate anesthesia, to reduce the sympathetic activity during the operation, to create prolonged anesthesia in the postoperative period and create favorable conditions for the surgeon’s work.
Aim. To study the changes of glaucoma prevalence from 1992 to 2012 and to define the main epidemiologic trends by statistical analysis. Methods. Considering the fact that 80% of patients with glaucoma who live in Irkutsk Region, undergo primary deep examination in the Interbranch Scientific and Research Complex «Eye Microsurgery» named after S.N. Fedorov, the gained data were extrapolated on the epidemiological situation in the region at whole. The analysis of 300 000 medical charts of patients who were diagnosed with glaucoma and attended the Irkutsk branch of Interbranch Scientific and Research Complex «Eye Microsurgery» named after S.N. Fedorov from 1992 to 2012 were analyzed, with the morbidity level assessment according to the following criteria: form and stage of glaucoma, gender, age, patients’ place of residence. The data were processed using regression analysis and analysis of variance. Results. The increase in glaucoma morbidity from 45.2 to 140.6 on 1000 examined patients, mainly affecting women, was revealed. A better detection of glaucoma on preclinical stages was noted. At the same time, the detection rate of glaucoma at advanced stages remains stable. Four periods, in which the prevalence growth significantly exceeds the predicted results, were determined. These periods corresponded to the introduction of new diagnostic technologies, conducting management measures, and change in staff of ophthalmologists. Conclusion. The obtained statistical results allow analyzing and estimating the epidemiologic situation on glaucoma, identifying the main trends of its development, getting prognostic models for key epidemiological indicators and can be used in prediction of the basic epidemiological trends.
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