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NR 1-3/2005
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Problemy okresu
okołooperacyjnego u chorych na dystrofię miotoniczną Steinerta,
operowanych z powodu zaćmy
Problems of perioperative
period in patients with Steinert’s myotonic dystrophy operated
due to cataract
Renata Zalewska1, Zofia Mariak1,
Elżbieta Markowska1, Sławomir Czaban2
1Z Kliniki Okulistyki Akademii Medycznej w
Białymstoku
Kierownik: dr hab. n. med. Zofia Mariak
2Z Zakładu Anestezjologii i Intensywnej Terapii
Akademii Medycznej w Białymstoku
Kierownik: dr n. med. Andrzej Siemiątkowski |
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| Summary: |
Steinert's myotonic
dystrophy is a genetically conditioned systemic disease
with symptoms related to circulatory, respiratory,
muscular, endocrine and mental disturbances. Most if not
all of these patients develop lens opacification as a
presenting symptom and need to undergo cataract surgery.
Nevertheless, selection of a type of anaesthesia can
arise to a problem in these patients because local
anaesthesia can be insufficient whereas general
endotracheal anaesthesia is known, to potentially
provoke serious postoperative complications.
In this contribution we discuss problems we faced during
cataract surgery in three siblings affected by
Steinert’s myotonic dystrophy. Two of them were operated
on in local anaesthesia and developed intraoperative
problems related to sudden increase of intraocular
pressure, bleeding and vitreous efflux. After receiving
a thorough examination the youngest of the three was
operated on under short acting general intravenous
anaesthesia (propofol and/or benzodiazepines, piperidine
derived opioids, non-polarizing paralytics). We conclude
that short acting general intravenous anaesthesia can
help in avoiding both, local ocular complications during
surgery and problems in the postoperative period. |
| Słowa kluczowe: |
dystrofia miotoniczna
Steinerta, operacja zaćmy, znieczulenie. |
| Key words: |
Steinert’s myotonic
dystrophy, cataract surgery, anaesthesia. |
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