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2011, Número 3

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Cir Cir 2011; 79 (3)


Trabeculectomía ab externo realizada bajo anestesia tópica con sedación consciente

Cortés-Gastélum MA, Paczka-Zapata JA, Mendoza-Barbosa JF

Idioma: Español
Referencias bibliográficas: 45
Paginas: 233-238
Archivo PDF: 253.87 Kb.


RESUMEN

Introducción: La trabeculectomía ab externo es el procedimiento quirúrgico más común para tratar el glaucoma; entre los métodos anestésicos se encuentra la anestesia tópica suplementada con sedación consciente, cuya eficacia y seguridad es evaluada en este estudio prospectivo.
Material y métodos: 26 pacientes consecutivos fueron sometidos a trabeculectomía bajo el efecto de anestesia tópica y sedación consciente; se evaluaron prospectivamente durante cinco momentos transoperatorios diferentes; se medió el grado de dolor a través de una escala visual análoga.
Resultados: fueron intervenidos 26 ojos; uno de los pacientes fue excluido por somnolencia excesiva. El momento de la iridectomía causó la menor tolerancia (p = 0.03), pero con valores aceptables en la escala de dolor (puntuación de dos, equivalente a molestia mínima pero soportable, p = 0.02), seguido del momento del cierre conjuntival (valores de p no significativos). Ningún paciente manifestó que globalmente la cirugía causara dolor de intensidad moderada o extrema (valores 4 y 5 de la escala, respectivamente). Al comparar el dolor, la tensión arterial, la frecuencia cardiaca y la saturación de oxígeno no se encontraron cambios estadísticamente significativos (p › 0.05). El 80% (n = 4) de los pacientes con iris verde o azul refirió síntomas, pero la significación estadística fue limítrofe (p = 0.053). No se presentaron efectos colaterales oculares o sistémicos relacionados con el esquema anestésico.
Conclusiones: La anestesia tópica con sedación consciente parece ser un método eficaz y seguro recomendable para realizar la trabeculectomía.


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