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Advisory for Postoperative Management. The consensus of
the Task Force is that a high-risk patient’s vision should be
assessed when the patient becomes alert (e.g., in the recovery
room, intensive care unit, or nursing floor). If there is concern
regarding potential visual loss, an urgent ophthalmologic consultation
should be obtained to determine its cause. Additional
management may include optimizing hemoglobin or hematocrit
values, hemodynamic status, and arterial oxygenation. To
rule out intracranial causes of visual loss, consider magnetic resonance
imaging. The Task Force believes that there is no role for
antiplatelet agents, steroids, or intraocular pressure-lowering
agents in the treatment of perioperative ION.
术后管理建议。特别小组一致认为,当高危患者自觉视觉异常时,应及时进行视力评估(如在恢复室、重症监护室或护理单元)。若考虑存在视觉缺失的潜在可能,应紧急请眼科会诊以明确原因。辅助处理措施包括优化血红蛋白或红细胞比容,稳定血流动力学状态及动脉血氧。同时,应用磁共振成像以排除颅内原因引起的视觉缺失。特别小组认为抗血小板药物,类固醇激素或降低眼内压药物对治疗围术期ION无效。
--------摘自Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery: A Update Report by the American Society of Anesthesiologists Task Force on Perioperative Visual Loss. Anesthesiology. 2012 Feb;116(2):274-85. |
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