Objective:To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.Methods:Relevant randomized controlled trials that compared the combin...Objective:To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.Methods:Relevant randomized controlled trials that compared the combined effect of music therapy for patients undergoing ophthalmic surgery were included.Four English databases and three Chinese databases were searched from inception to Jan.2022.Two reviewers independently performed data extraction and risk of bias assessments.The Cochrane Collaboration tool was used to assess the risk of bias.Meta-analysis was performed using Review Manager 5.3.The outcomes were overall anxiety,blood pressure,heart rate and pain.Results:A total of 11 trials with 1,469 participants were included in the meta-analysis.Compared to standard care,music therapy had a good effect on reducing the anxiety levels of patients undergoing ophthalmic surgery(P<0.05).The results also suggested that music therapy produced a significant improvement in blood pressure(P<0.05)and heart rate(P<0.05).The visual analogue scale(VAS)showed that music therapy significantly reduced pain compared to standard care(P<0.05).Conclusions:This meta-analysis provided evidence that music therapy has an obvious effect on relieving anxiety levels,while it is also more effective in alleviating pain and improving physiological responses than standard care alone.Our findings may provide accurate evidence-based guidance for the clinical implementation of music therapy.In the future,more high-quality studies are required for verifying these results.展开更多
BACKGROUND Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic procedure.Some oculoplastic conditions,like nasolacrimal duct obstruction,have ...BACKGROUND Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic procedure.Some oculoplastic conditions,like nasolacrimal duct obstruction,have been extensively studied,whereas others,like eyelid malposition and thyroid eye disease,have received minimal or no research.AIM To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic intervention.METHODS A cross-sectional survey was disseminated among ophthalmologists all over India.The survey included questions related to pre-operative evaluation,anaesthetic and surgical techniques preferred,post-operative care,the use of adjunctive therapies,and patient follow-up patterns.RESULTS A total of 180 ophthalmologists responded to the survey.Most practitioners(89%)felt that the ROPLAS test was sufficient during pre-operative evaluation before any subspecialty surgery was advised.The most common surgical techniques employed were lacrimal drainage procedures(Dacryocystorhinostomy)(63.3%),eyelid malposition repair(36.9%),and ptosis repair(58.7%).Post-operatively,47.7%of respondents emphasized that at least a 4-week gap should be maintained after lacrimal drainage procedures and eyelid surgeries.Sixty-seven percent of ophthalmologists felt that topical anaesthetic procedures should be preferred while performing ocular surgeries in thyroid eye disease patients.CONCLUSION Approximately 50%of ophthalmologists handle prevalent oculoplastic issues themselves,seeking the expertise of an oculoplastic surgeon under particular conditions.Many ophthalmologists still favor using ROPLAS as a preliminary screening method before proceeding with cataract surgery.Eyelid conditions and thyroid eye disease are not as commonly addressed before subspecialty procedures compared to issues like nasolacrimal duct obstruction and periocular infections.展开更多
AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This mul...AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This multicenter,prospective,randomized,double-masked,parallel-controlled,non-inferiority trial was conducted in three ophthalmology clinical centers in China.Patients with retinal detachment,who were eligible for PPV were consecutively enrolled.Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio.Best-corrected visual acuity(BCVA),intraocular pressure(IOP)measurement,and dilated fundus examination were performed preoperatively and at 1,7±1,28±3d postoperatively.The primary outcome was complete retinal reattachment rate at postoperative day one.The non-inferiority margin was set at 9.8%.The secondary outcomes included intraoperative retinal reattachment rate,and mean changes in IOP and BCVA from baseline to 1,7±1,28±3d postoperatively,respectively.Safety analyses were presented for all randomly assigned participates in this study.RESULTS:Totally 124 eligible patients completed the study between Mar.14,2016 and Jun.7,2017.Sixty of them were randomly assigned to the PFO for ophthalmic surgery group,and 64 were assigned to the F-Octane group.Baseline characteristics were comparable between the two groups.Both groups achieved 100%retinal reattachment at postoperative day one(difference 0,95%CI:-6.21%to 5.75%,P=1).The pre-defined noninferiority criterion was met.No significant difference was observed in intraoperative retinal reattachment rate(difference 1.77%,P=0.61),mean changes in IOP(difference 0.36,-0.09,2.22 mm Hg at 1,7±1,28±3d postoperatively,with all P>0.05)and BCVA(difference 0.04,-0.02,0.06 logMAR at 1,7±1,28±3d postoperatively,all P>0.05)between the two groups.No apparent adverse events related to the utilization of PFO were reported.CONCLUSION:In patients with retinal detachment undergoing PPV,PFO for ophthalmic surgery is non-inferior to F-Octane as an intraocular tamponade,and both are safe and well-tolerated.展开更多
Endophthalmitis is a severe ocular infection which can have sight threatening complications and should be treated urgently. Malta is an archipelago in the middle of the Mediterranean sea, with one main hospital (Mater...Endophthalmitis is a severe ocular infection which can have sight threatening complications and should be treated urgently. Malta is an archipelago in the middle of the Mediterranean sea, with one main hospital (Mater Dei Hospital), where all emergency ophthalmic cases are referred during the years audited. This allowed the authors to review all the cases of endophthalmitis which presented to Mater Dei Hospital from 2009 to 2020 and to be able to reliably compare incidence of local endophthalmitis cases with worldwide quoted incidence rates. All theatre logbooks documenting procedures locally from 2009 to 2020 were reviewed and patients undergoing intravitreal tap and antibiotics injections were included in this audit. This was based on the assumption that all endophthalmitis cases which presented underwent these procedures. Data was analyzed and the average incidence of endophthalmitis cases noted and compared with international numbers. The local numbers are higher than the accepted average, taking into consideration sources of error during data collection for this audit. The authors suggest that a local standard operating procedure in terms of response of suspected endophthalmitis is needed as well as a register for local endophthalmitis cases.展开更多
AIM: To compare the effect of propofol versus urapidil on hemodynamics and intraocular pressure during anesthesia and extubation for ophthalmic patients. METHODS: Eighty-two surgical patients (Class: ASA I-II) were ra...AIM: To compare the effect of propofol versus urapidil on hemodynamics and intraocular pressure during anesthesia and extubation for ophthalmic patients. METHODS: Eighty-two surgical patients (Class: ASA I-II) were randomly assigned to propofol (n = 41) and urapidil groups (n = 41). Their gender, age, body mass, operation time and dosage of anesthetics had no significant difference between the two groups (P > 0.05). The patients of propofol and urapidil groups were given propofol (1.5mg/kg) and urapidil (2.5mg/kg) respectively; and two drugs were all diluted with normal saline to 8mL. Then the drugs were given to patients by slow intravenous injection. After treatment, the patients were conducted immediate suction, tracheal extubation, and then patients wore oxygen masks for 10 minutes. By double-blind methods, before the induction medication, at the suction, and 5, 10 minutes after the extubation, we recorded the systolic and diastolic blood pressure (BP), heart rate (HR), pH, PaO2, PaCO2, SaO(2) and intraocular pressure (TOP) respectively. The complete recovery time of the patients with restlessness (on the command they could open eyes and shaking hands) was also recorded during the extubation. The data were analyzed by using a professional SPSS 15.0 statistical software. RESULTS: The incidence of cough, restlessness and glossocoma was significantly lower in the propofol group than that in the urapidil group after extubation (P < 0.05). There were no episodes of hypotension, laryngospasm, or severe respiratory depression. There was no statistical difference in recovery time between two groups (P > 0.05). In propofol group, the BP and HR during extubation and thereafter had no significant difference compared with those before induction, while they were significantly lower than those before giving propofol (P < 0.05), and had significant difference compared with those in urapidil group (P < 0.05). Compared to preinduction, the BP of urapidil group showed no obvious increase during aspiration and extubation. The HR of urapidil group had little changes after being given urapidil, and it was obviously increased compared with that before induction. The stimulation of aspiration and extubation caused less cough and agitation in propofol group than that in urapidil group (P < 0.05). The IOP of propofol group showed no obvious increase during extubation compared with that in preinduction, while in the urpidil group, extubation caused IOP significantly increased (P < 0.05). The changes in these indicators between the two groups had no significant difference (P > 0.05). CONCLUSION: Compared to urapidil, propofol is superior for preventing the cardiovascular and stress responses and IOP increases during emergence and extubation for the ophthalmic patients. Moreover, it has no effects on patient's recovery.展开更多
BACKGROUND Apnea caused by retrobulbar anesthesia is a very rare but severe complication during ophthalmic surgery.CASE SUMMARY We report a rare case of apnea caused by retrobulbar anesthesia,and emergency resuscitati...BACKGROUND Apnea caused by retrobulbar anesthesia is a very rare but severe complication during ophthalmic surgery.CASE SUMMARY We report a rare case of apnea caused by retrobulbar anesthesia,and emergency resuscitation was used.A 74-year-old female patient was diagnosed with rhegmatogenous retinal detachment in the right eye and planned to undergo vitrectomy under retrobulbar anesthesia.After the retrobulbar anesthesia in her right eye,she became unconscious and apneic.It was suggested that she had developed brainstem anesthesia.Assisted ventilation was initiated.Atropine 0.5 mg,epinephrine 1 mg,ephedrine 30 mg,and lipid emulsion were given.Five minutes later,her consciousness and breathing gradually returned,but with uncertain light perception in her right eye.Alprostadil 20μg was given,and after 2 h her visual acuity resumed to the preoperative level.CONCLUSION Brainstem anesthesia is a serious complication secondary to retrobulbar anesthesia.Medical staff should pay attention to the identification of brainstem anesthesia and be familiar with the emergency treatment for this complication.展开更多
文摘Objective:To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.Methods:Relevant randomized controlled trials that compared the combined effect of music therapy for patients undergoing ophthalmic surgery were included.Four English databases and three Chinese databases were searched from inception to Jan.2022.Two reviewers independently performed data extraction and risk of bias assessments.The Cochrane Collaboration tool was used to assess the risk of bias.Meta-analysis was performed using Review Manager 5.3.The outcomes were overall anxiety,blood pressure,heart rate and pain.Results:A total of 11 trials with 1,469 participants were included in the meta-analysis.Compared to standard care,music therapy had a good effect on reducing the anxiety levels of patients undergoing ophthalmic surgery(P<0.05).The results also suggested that music therapy produced a significant improvement in blood pressure(P<0.05)and heart rate(P<0.05).The visual analogue scale(VAS)showed that music therapy significantly reduced pain compared to standard care(P<0.05).Conclusions:This meta-analysis provided evidence that music therapy has an obvious effect on relieving anxiety levels,while it is also more effective in alleviating pain and improving physiological responses than standard care alone.Our findings may provide accurate evidence-based guidance for the clinical implementation of music therapy.In the future,more high-quality studies are required for verifying these results.
文摘BACKGROUND Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic procedure.Some oculoplastic conditions,like nasolacrimal duct obstruction,have been extensively studied,whereas others,like eyelid malposition and thyroid eye disease,have received minimal or no research.AIM To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic intervention.METHODS A cross-sectional survey was disseminated among ophthalmologists all over India.The survey included questions related to pre-operative evaluation,anaesthetic and surgical techniques preferred,post-operative care,the use of adjunctive therapies,and patient follow-up patterns.RESULTS A total of 180 ophthalmologists responded to the survey.Most practitioners(89%)felt that the ROPLAS test was sufficient during pre-operative evaluation before any subspecialty surgery was advised.The most common surgical techniques employed were lacrimal drainage procedures(Dacryocystorhinostomy)(63.3%),eyelid malposition repair(36.9%),and ptosis repair(58.7%).Post-operatively,47.7%of respondents emphasized that at least a 4-week gap should be maintained after lacrimal drainage procedures and eyelid surgeries.Sixty-seven percent of ophthalmologists felt that topical anaesthetic procedures should be preferred while performing ocular surgeries in thyroid eye disease patients.CONCLUSION Approximately 50%of ophthalmologists handle prevalent oculoplastic issues themselves,seeking the expertise of an oculoplastic surgeon under particular conditions.Many ophthalmologists still favor using ROPLAS as a preliminary screening method before proceeding with cataract surgery.Eyelid conditions and thyroid eye disease are not as commonly addressed before subspecialty procedures compared to issues like nasolacrimal duct obstruction and periocular infections.
基金Supported by the Program of Shanghai Academic/Technology Research Leader(No.21XD1402700)the Clinical Research Plan of Shenkang Hospital Development Center of Shanghai(No.SHDC2022CRD001).
文摘AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This multicenter,prospective,randomized,double-masked,parallel-controlled,non-inferiority trial was conducted in three ophthalmology clinical centers in China.Patients with retinal detachment,who were eligible for PPV were consecutively enrolled.Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio.Best-corrected visual acuity(BCVA),intraocular pressure(IOP)measurement,and dilated fundus examination were performed preoperatively and at 1,7±1,28±3d postoperatively.The primary outcome was complete retinal reattachment rate at postoperative day one.The non-inferiority margin was set at 9.8%.The secondary outcomes included intraoperative retinal reattachment rate,and mean changes in IOP and BCVA from baseline to 1,7±1,28±3d postoperatively,respectively.Safety analyses were presented for all randomly assigned participates in this study.RESULTS:Totally 124 eligible patients completed the study between Mar.14,2016 and Jun.7,2017.Sixty of them were randomly assigned to the PFO for ophthalmic surgery group,and 64 were assigned to the F-Octane group.Baseline characteristics were comparable between the two groups.Both groups achieved 100%retinal reattachment at postoperative day one(difference 0,95%CI:-6.21%to 5.75%,P=1).The pre-defined noninferiority criterion was met.No significant difference was observed in intraoperative retinal reattachment rate(difference 1.77%,P=0.61),mean changes in IOP(difference 0.36,-0.09,2.22 mm Hg at 1,7±1,28±3d postoperatively,with all P>0.05)and BCVA(difference 0.04,-0.02,0.06 logMAR at 1,7±1,28±3d postoperatively,all P>0.05)between the two groups.No apparent adverse events related to the utilization of PFO were reported.CONCLUSION:In patients with retinal detachment undergoing PPV,PFO for ophthalmic surgery is non-inferior to F-Octane as an intraocular tamponade,and both are safe and well-tolerated.
文摘Endophthalmitis is a severe ocular infection which can have sight threatening complications and should be treated urgently. Malta is an archipelago in the middle of the Mediterranean sea, with one main hospital (Mater Dei Hospital), where all emergency ophthalmic cases are referred during the years audited. This allowed the authors to review all the cases of endophthalmitis which presented to Mater Dei Hospital from 2009 to 2020 and to be able to reliably compare incidence of local endophthalmitis cases with worldwide quoted incidence rates. All theatre logbooks documenting procedures locally from 2009 to 2020 were reviewed and patients undergoing intravitreal tap and antibiotics injections were included in this audit. This was based on the assumption that all endophthalmitis cases which presented underwent these procedures. Data was analyzed and the average incidence of endophthalmitis cases noted and compared with international numbers. The local numbers are higher than the accepted average, taking into consideration sources of error during data collection for this audit. The authors suggest that a local standard operating procedure in terms of response of suspected endophthalmitis is needed as well as a register for local endophthalmitis cases.
基金National Natural Science Foundation of China (No.39580683)
文摘AIM: To compare the effect of propofol versus urapidil on hemodynamics and intraocular pressure during anesthesia and extubation for ophthalmic patients. METHODS: Eighty-two surgical patients (Class: ASA I-II) were randomly assigned to propofol (n = 41) and urapidil groups (n = 41). Their gender, age, body mass, operation time and dosage of anesthetics had no significant difference between the two groups (P > 0.05). The patients of propofol and urapidil groups were given propofol (1.5mg/kg) and urapidil (2.5mg/kg) respectively; and two drugs were all diluted with normal saline to 8mL. Then the drugs were given to patients by slow intravenous injection. After treatment, the patients were conducted immediate suction, tracheal extubation, and then patients wore oxygen masks for 10 minutes. By double-blind methods, before the induction medication, at the suction, and 5, 10 minutes after the extubation, we recorded the systolic and diastolic blood pressure (BP), heart rate (HR), pH, PaO2, PaCO2, SaO(2) and intraocular pressure (TOP) respectively. The complete recovery time of the patients with restlessness (on the command they could open eyes and shaking hands) was also recorded during the extubation. The data were analyzed by using a professional SPSS 15.0 statistical software. RESULTS: The incidence of cough, restlessness and glossocoma was significantly lower in the propofol group than that in the urapidil group after extubation (P < 0.05). There were no episodes of hypotension, laryngospasm, or severe respiratory depression. There was no statistical difference in recovery time between two groups (P > 0.05). In propofol group, the BP and HR during extubation and thereafter had no significant difference compared with those before induction, while they were significantly lower than those before giving propofol (P < 0.05), and had significant difference compared with those in urapidil group (P < 0.05). Compared to preinduction, the BP of urapidil group showed no obvious increase during aspiration and extubation. The HR of urapidil group had little changes after being given urapidil, and it was obviously increased compared with that before induction. The stimulation of aspiration and extubation caused less cough and agitation in propofol group than that in urapidil group (P < 0.05). The IOP of propofol group showed no obvious increase during extubation compared with that in preinduction, while in the urpidil group, extubation caused IOP significantly increased (P < 0.05). The changes in these indicators between the two groups had no significant difference (P > 0.05). CONCLUSION: Compared to urapidil, propofol is superior for preventing the cardiovascular and stress responses and IOP increases during emergence and extubation for the ophthalmic patients. Moreover, it has no effects on patient's recovery.
文摘BACKGROUND Apnea caused by retrobulbar anesthesia is a very rare but severe complication during ophthalmic surgery.CASE SUMMARY We report a rare case of apnea caused by retrobulbar anesthesia,and emergency resuscitation was used.A 74-year-old female patient was diagnosed with rhegmatogenous retinal detachment in the right eye and planned to undergo vitrectomy under retrobulbar anesthesia.After the retrobulbar anesthesia in her right eye,she became unconscious and apneic.It was suggested that she had developed brainstem anesthesia.Assisted ventilation was initiated.Atropine 0.5 mg,epinephrine 1 mg,ephedrine 30 mg,and lipid emulsion were given.Five minutes later,her consciousness and breathing gradually returned,but with uncertain light perception in her right eye.Alprostadil 20μg was given,and after 2 h her visual acuity resumed to the preoperative level.CONCLUSION Brainstem anesthesia is a serious complication secondary to retrobulbar anesthesia.Medical staff should pay attention to the identification of brainstem anesthesia and be familiar with the emergency treatment for this complication.
