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A Department-of-Anesthesiology-based management protocol for perioperative corneal abrasions.

Lichter JR, Marr LB, Schilling DE, Hudson ME, Boretsky RH, Barad RF, Chelly JE - Clin Ophthalmol (2015)

Bottom Line: To decrease this waiting period - and thereby increase patient satisfaction - we developed an anesthesiology-based protocol to manage minor CAs arising in the recovery room.All patients experienced resolution of symptoms by the morning following their complaint.Minor CAs can be safely and effectively managed using an anesthesiology-based approach.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical Research, Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA.

ABSTRACT

Introduction: Corneal abrasions (CAs) are the most prevalent ocular injuries in the perioperative period. Previously, patients at our community hospital would wait for an ophthalmologist to be available to manage these minor injuries. To decrease this waiting period - and thereby increase patient satisfaction - we developed an anesthesiology-based protocol to manage minor CAs arising in the recovery room. The current study sought to assess this protocol's efficacy as well as further establish the incidence and some risk factors of CA.

Methods: This was a hospital-based, observational study. As per protocol, anesthesiologists saw and diagnosed any patient exhibiting symptoms of CA, after which they initiated a preestablished treatment regimen. To examine the efficacy of this protocol between March 2007 and December 2011, the number of CAs anesthesiologists managed and time to treatment were recorded. Additionally, the frequency of CAs was established along with some of their risk factors.

Results: Throughout the study period, there were 91,064 surgical cases, with 118 CAs (0.13% incidence). Anesthesiology alone managed 110 (93.22%) of these cases. The median time between the end of anesthesia to the time of prescribed ophthalmic medication was 156 minutes (first-third interquartile range: 108-219). All patients experienced resolution of symptoms by the morning following their complaint. Compared to the general surgical population, CA patients were older (P<0.01) and underwent longer surgeries (P<0.01).

Conclusion: Minor CAs can be safely and effectively managed using an anesthesiology-based approach. Advanced age and longer surgery are confirmed as risk factors for these injuries.

No MeSH data available.


Related in: MedlinePlus

Algorithm for the management of preoperative corneal abrasions.Abbreviation: PACU, post-anesthesia care unit.
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f1-opth-9-1689: Algorithm for the management of preoperative corneal abrasions.Abbreviation: PACU, post-anesthesia care unit.

Mentions: For most patients, a combination of eye drops is the most effective method for healing CAs.7 Given this regimen’s simplicity, requiring that patients wait to see a specialist for the care of CAs seems especially unnecessary. Hence, to lessen the time between symptom onset and treatment – and in turn patient suffering and dissatisfaction – an anesthesiology-based protocol for the management of minor CAs identified in the post-anesthesia care unit (PACU) was developed with input from ophthalmology (Figure 1). This protocol became the standard approach at our institution. The current study sought to assess the effectiveness of this anesthesiology-based protocol, as well as clarify the incidence of CA and examine some of its associated risk factors.


A Department-of-Anesthesiology-based management protocol for perioperative corneal abrasions.

Lichter JR, Marr LB, Schilling DE, Hudson ME, Boretsky RH, Barad RF, Chelly JE - Clin Ophthalmol (2015)

Algorithm for the management of preoperative corneal abrasions.Abbreviation: PACU, post-anesthesia care unit.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4574851&req=5

f1-opth-9-1689: Algorithm for the management of preoperative corneal abrasions.Abbreviation: PACU, post-anesthesia care unit.
Mentions: For most patients, a combination of eye drops is the most effective method for healing CAs.7 Given this regimen’s simplicity, requiring that patients wait to see a specialist for the care of CAs seems especially unnecessary. Hence, to lessen the time between symptom onset and treatment – and in turn patient suffering and dissatisfaction – an anesthesiology-based protocol for the management of minor CAs identified in the post-anesthesia care unit (PACU) was developed with input from ophthalmology (Figure 1). This protocol became the standard approach at our institution. The current study sought to assess the effectiveness of this anesthesiology-based protocol, as well as clarify the incidence of CA and examine some of its associated risk factors.

Bottom Line: To decrease this waiting period - and thereby increase patient satisfaction - we developed an anesthesiology-based protocol to manage minor CAs arising in the recovery room.All patients experienced resolution of symptoms by the morning following their complaint.Minor CAs can be safely and effectively managed using an anesthesiology-based approach.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical Research, Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA.

ABSTRACT

Introduction: Corneal abrasions (CAs) are the most prevalent ocular injuries in the perioperative period. Previously, patients at our community hospital would wait for an ophthalmologist to be available to manage these minor injuries. To decrease this waiting period - and thereby increase patient satisfaction - we developed an anesthesiology-based protocol to manage minor CAs arising in the recovery room. The current study sought to assess this protocol's efficacy as well as further establish the incidence and some risk factors of CA.

Methods: This was a hospital-based, observational study. As per protocol, anesthesiologists saw and diagnosed any patient exhibiting symptoms of CA, after which they initiated a preestablished treatment regimen. To examine the efficacy of this protocol between March 2007 and December 2011, the number of CAs anesthesiologists managed and time to treatment were recorded. Additionally, the frequency of CAs was established along with some of their risk factors.

Results: Throughout the study period, there were 91,064 surgical cases, with 118 CAs (0.13% incidence). Anesthesiology alone managed 110 (93.22%) of these cases. The median time between the end of anesthesia to the time of prescribed ophthalmic medication was 156 minutes (first-third interquartile range: 108-219). All patients experienced resolution of symptoms by the morning following their complaint. Compared to the general surgical population, CA patients were older (P<0.01) and underwent longer surgeries (P<0.01).

Conclusion: Minor CAs can be safely and effectively managed using an anesthesiology-based approach. Advanced age and longer surgery are confirmed as risk factors for these injuries.

No MeSH data available.


Related in: MedlinePlus