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    Paradigm Shift of Ophthalmic Surgery Anesthesia

    AAO 2022 Video Program
    Comprehensive Ophthalmology, Cornea/External Disease

    This video discusses the use of low-concentration nitrous oxide (N2O) anesthesia in combination with local anesthesia in ophthalmic surgery. Ptosis, cataract, and vitreoretinal surgery patients with normal local anesthesia and N2O were retrospectively analyzed in terms of vital change, operation feeling, and intraocular pressure (IOP). The effectiveness of N2O in pediatric surgery, as well as for patients with dementia, claustrophobia, and tremors, was also investigated. Results showed that the increase in blood pressure and heart rate of patients in the N2O group was significantly suppressed (all P < .05). Pain and anxiety and intraoperative memory were also suppressed in patients in the N2O group. It was observed that N2O suppressed severe claustrophobia, body movement, and nystagmus, and eliminated tremors in children. The increase in IOP with N2O during gas replacement surgery was not significantly different from that without N2O use. No other side effects were noted. Overall, N2O was found to stabilize vital signs and several intraoperative symptoms without side effects.

    Financial Disclosures: Drs. Santaro Noguchi and Asuka Noguchi disclose no financial relationships.