General anæsthesia in 350 cataract extractions

Abstract

General anaesthesia for intra-ocular surgery still presents a topic of controversy. Most ophthalmic surgeons agree to the use of general anasthesia for extra-ocular surgery or for intra-ocular operations on children. The use of general anzsthesia for cataract extractions on adults is increasing.Cridlandl advocated total general anaesthesia and endotracheal intubation, pointing out, that the full co-operation needed from a patient under local analgesia cannot be achieved in a state of sedation, however complete the pre-operative instructions. To this may be added the frequency of senility or deafness as barriers to complete co-operation in the patients commonly subjected to cataract extractions.These considerations equally apply to the use, suggested by Kirby2 and Ives3, of a state of semi-consciousness induced by the lytic cocktail combined with akinesia through relaxants and retrobulbar injections of a local analgesic. This paper will consider the low incidence of post-operative vomiting, cough and restlessness in a series of 350 cases of cataract extractions and will also deal with the occurrence of intra-ocular complications.

General Anaesthesia in Intra‐ocular Surgery

“…Patients and surgeons prefer general anaesthesia if properly administered (Goldsmith 1961). Although there are different opinions on the ultimate place of halothane in modern anaesthesia, it has many useful properties which are specially indicated here.…”

“…General Anaesthesia in intra-ocular surgery IS not as widely used as it should be, although ~here . has been a trend towards this method In recent years (Goldsmith 1961 ;Sandiford 1957), Before advances in modern anaesthesia there was always the possibility of sudden movement, coughing, straining, or squeezing of ~he eyelids at an inopportune moment. Raised Intra-ocular pressure with vitreous loss, intra-0_cular bleeding or congestion of the operative field were all potential dangers likely to be aggravated by post-operative vomiting or restlessness.…”

“…General Anaesthesia in intra‐ocular surgery is not as widely used as it should be, although there has been a trend towards this method in recent years (Goldsmith 1961 ; Sandiford 1957). Before advances in modern anaesthesia there was always the possibility of sudden movement, coughing, straining, or squeezing of the eyelids at an inopportune moment.…”