[New anaesthetic technique in diode laser treatment of retinopathy of prematurity]

An Pediatr (Barc). 2008 Jun;68(6):576-80. doi: 10.1157/13123289.
[Article in Spanish]

Abstract

Introduction: Anaesthesia in premature infants can have many complications. Although the application of diode laser is less painful than cryotherapy, there has to be adequate immobilization of the patient to provide a correct focus of the spot. At Hospital Infantil de Zaragoza, the same standard anaesthetic technique has been applied since 1999, obtaining sedation with inhaled anaesthetic agents combined with topical anaesthesia. We analyse the results obtained on the application of this technique.

Material and method: The study included 72 consecutive premature infants treated with diode laser for retinopathy of prematurity (ROP), using an anaesthetic technique combining inhalatory sedation and topical anaesthesia. The personal data of each patient was collected (gestational age, birth weight, postconceptional age at the time of initial treatment, associated systemic disorders) together with information related to the surgical intervention (duration, intraoperative and postoperative complications).

Results: Intraoperative complications occurred in 12 cases (16.66%). These were self-limited in 9 cases and only 3 cases required orotracheal intubation (4.16%). Postoperative complications occurred in 4 cases (5.55%) during the 48 h following treatment. No statistically significant relationship was found between the presence of intraoperative complications and the mean gestational age and birth weight, and the presence of apnoea, intraventricular haemorrhage or a permeable ductus. A statistically significant relationship was found between the presence of postoperative complications and significant intraventricular haemorrhage.

Conclusions: This anaesthetic technique combining inhalatory gases and topical anaesthesia is safe, with few complications and comfortable for the surgeon.

Publication types

  • English Abstract

MeSH terms

  • Administration, Topical
  • Anesthesia / methods*
  • Anesthetics, Local / administration & dosage*
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Infant, Newborn
  • Intraoperative Complications / epidemiology
  • Lasers, Semiconductor / therapeutic use*
  • Postoperative Complications / epidemiology
  • Retinopathy of Prematurity / therapy*

Substances

  • Anesthetics, Local
  • Hypnotics and Sedatives