Ophthalmology ReportsOphthalmology Reports1998-71022412-5423Eco-Vector778410.17816/OV10418-23Research ArticleRole of pterygopalatine blockade in the early rehabilitation program of children after congenital cataract surgeryShchukoAndrey G.<p>DM, Professor, honored MD of Russian Federation, Branch manager</p>kripak_mntk@mail.ruIurevaTatiana N.<p>MD, Professor, Deputy Director for research</p>tnyurieva@mail.ruOleshchenkoIrina G.<p>anesthesiologist-resuscitator</p>iga.oleshenko@mail.ruIrkutsk Branch of S. Fyodorov Eye Microsurgery Federal State InstitutionIrkutsk State Medical UniversityIrkutsk State Medical Academy of Continuing Education15122017104182331012018Copyright © 2017, Shchuko A.G., Iureva T.N., Oleshchenko I.G.2017<p>Nowadays, the surgical treatment of congenital cataract is a small-incisions surgery (aspiration, in some cases ultrasound phacoemulsification). It corresponds to the Fast Track surgery principles, and as a quick recovery technology it requires optimization of pain control in the early postoperative period. </p>
<p><strong>Purpose</strong>. To estimate the efficiency of the pterygopalatine block as a component of an optimized Fast Track protocol in children after congenital cataract surgery.</p>
<p><strong>Materials and methods</strong>. 54 children operated for congenital cataract were included in the study. All patients were divided into 2 groups. In the first group (n = 26), a regional component of combined anesthesia on sevoflurane basis was carried out in combination with a pterygopalatine block; in the second group (n = 28), there was an implementation of a retrobulbar block. The efficiency of the methods was evaluated by a comparative analysis of hemodynamic parameters, the index of the vegetative system tension, the assessment of pain intensity by a verbal rating scale, as well as by the severity of ocular inflammatory reactions.</p>
<p><strong>Results</strong>. Obtained data show that the pterygopalatine ganglion block as a component of a combined anesthesia in congenital cataract surgery allows providing adequate anesthesia, creating prolonged pain control, reducing the inflammatory reaction in postoperative period during the first 24 hours.</p>
<p><strong>Conclusion</strong>. On the basis of our analysis, the possibility of a safe implementation of optimized (Fast-Track) protocol was proven.</p>congenital cataractpterygopalatine blockFast-Track protocolврождённая катарактакрылонёбная блокадапротокол Fast Track[1. Азолов В.В., Максимов Г.А., Акулов И.С. Регионарная анестезия и микроциркуляция при реконструктивных операциях на кисти // VI Всерос. съезд анестезиологов и реаниматологов: тезисы докладов. – М., 1988. – С. 53. [Azolov VV, Maximov GA, Akulov IS. Regional anesthesia and microcirculation in reconstructive surgery on wrist. In: VI All-Russian Meeting of Anesthesiologists and Resuscitation Specialist: Reports Thesis (Conference proceedings). Moscow; 1988. P. 53. (In Russ.)]][2. Айзенберг В.Л., Ульрих Г.Э., Цыпин Л.Е., Заболотский Д.В. Регионарная анестезия в педиатрии // Регионарная анестезия и лечение острой боли. – 2016. – Т. 8. – № 4. – С. 41–49. [Aizenberg VL, Ul’rikh GE, Tsypin LE, Zabolotskiy DV. Regional anesthesia in pediatrics. Regionarnaya anesteziya i lechenie ostroy boli. 2014;8(4):41-49. (In Russ.)]][3. Боброва Н.Ф. Имплантация складывающихся ИОЛ AcrySof у детей / VII съезд офтальмологов России: тез. докл. – М., 2000. – Ч. 2. – С. 335–336. [Bobrova NF. Implantation of folding IOL AcrySof in children. VII s»yezd oftal’mologov Rossii (Conference proceedings). Мoscow; 2000. P. 335-336. (In Russ.)]][4. Насонов Е.Л., Насонова В.А. Фармакотерапия боли: взгляд ревматолога // Consilium Medicum. – 2000. – Т. 2. – № 12. – С. 509–514. [Nasonov YeL, Nasonova VA. Pharmacotherapy of pain: a look of a rheumatologist. Consilium Medicum. 2000;2(12):509-514. (In Russ.)]][5. Grigoraş I. Fast-trach surgery – a new concept – the perioperative anesthetic management. Jurnalul de Chirurgie, Iasi. 2007;3(2):89-91.][6. Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248:189-198. doi: 10.1097/SLA.0b013e31817f2c1a.][7. Molmenti EP, Ziambaras Т, Perlmutter DH. Evidence for an acute phase response in human intestinal epithelial cells. J Biol Chem. 1993;268:14116-14124.]