Anesthesia for Ophthalmic Artery Chemosurgery

Abstract

Pediatric anesthesiologists should be aware of severe cardiopulmonary events that can occur during intraarterial chemotherapy for retinoblastoma.

Prospective analysis of serious cardiorespiratory events in children during ophthalmic artery chemotherapy for retinoblastoma under a deep standardized anesthesia

“…Regarding the pathophysiology of this sudden and profound decrease in lung compliance, 3 potential causes could be considered, namely acute pulmonary edema, anaphylactic reaction, and bronchospasm. As the first 2 hypotheses appear unlikely, this respiratory complication is probably due to an atypical form of bronchospasm …”

“…As the first 2 hypotheses appear unlikely, this respiratory complication is probably due to an atypical form of bronchospasm …”

Cardiorespiratory Events in Children During Chemoembolization of Ophthalmic Artery for Retinoblastoma

“…Since there were no secretions through the orotracheal tube, and there was a quick resolution, the diagnosis of edema was unlikely. The negative levels of tryptase in a case series [ 12 ] decrease the likelihood accounting for these symptoms for an anaphylactic reaction.…”

“…To date, there is no consensus regarding optimal management; however, our experience and prior authors agree in certain aspects. Oxygen support to 100% must be instated as soon as possible, and early use of epinephrine should be instated (1 ucg/Kg up to 10 ucg/Kg) [ 5 , 12 ] even if there isn't hemodynamic compromise since this has been shown to improve bronchospasm significantly [ 12 ].…”

Occurrence of Cardio-respiratory reflex during ophthalmic artery embolisation in the neurointervention radiology suite

“…The occurrence of cardio-respiratory reflex (CRR) is a rare complication in ophthalmic surgeries. [12] CRR is considered as one of the rare probable causes of decreased lung compliance during ophthalmic artery (OA) chemotherapy. [12]…”