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Anna Berry, Jason Sokol, Peter Timoney; Current Anesthetic Practices Among Oculoplastic Surgeons. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4733.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the practice of and influencing factors on the choice of anesthesia for various orbital surgeries by Oculoplastic surgeons.
An IRB exempt anonymous survey using REDCap electronic capture tools hosted at University of Kansas Medical Center was sent via email to the American Society of Ophthalmic Plastic & Reconstructive Surgery (ASPORS) members. The survey contained two parts for each surgical procedure: anesthetic preference and primary influencing factor. Demographics including number of years in practice and practice type were also collected. Responses were analyzed using standard statistical methods.
One hundred and eighteen ASOPRS members responded to the survey during a two-week period for a response rate of 23.6%. General anesthesia was the anesthetic method of choice for eight of the nine surgical procedures: enucleation (88.1%), evisceration (74.6%), external dacryocystorhinostomy (DCR) (54.2%), endoscopic DCR (55.1%), endoscopic brow lift (37.3%), external ethmoidectomy (49.2%), orbital floor decompression (95.8%), and lateral wall orbital decompression (94.1%). Monitored anesthesia care (MAC) was the anesthetic of choice for open brow lift (68.6%). “Current facility practices” was the primary factor for anesthetic choice with endoscopic DCR (30.0%), open brow lift (32.2%), and endoscopic brow lift (32.2%). “Fellowship training” was the primary choice with orbital floor decompression (45.8%) and lateral wall orbital decompression (44.9%). The category “other” was the primary factor for enucleation (50.9%), evisceration (50.9%), external DCR (42.4%) and external ethmoidectomy (20.3%). Patient comfort was the most frequent response for “other” for each surgical procedure.
General anesthesia is the most common anesthetic method used but the underlying reasoning for the choice varied by surgical procedure. The most agreement by ASOPRS members on anesthetic choice was found, in descending order, for orbital floor decompression, lateral wall orbital decompression, enucleation, and evisceration.
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