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Subjective and objective assessment of topical anesthesia during cataract surgery

Poster Details

First Author: O.Mishchenko RUSSIA

Co Author(s):    I. Oleschenko   T. Iureva   M. Gasparyan              

Abstract Details


Improvement of surgical technologies changed the principles of anesthesia in the treatment of cataracts. To date, topical anesthesia is used as an independent method of anesthesia. So far, there are no data on the features of the state of vegetative nervous system during surgery under topical anesthesia in reflexogenic zones, their activation can lead to a change in hemodynamics and the development of the oculo-cardial reflex, which is especially important in ophthalmosurgery. Purpose: To investigate the change in the tonus of the vegetative nervous system and hemodynamics in patients operated for cataracts under topical anesthesia.


S. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk, Russia Irkutsk State Medical University, Russia ISMAPgE – Branch Campus of the FSBEI FPE RMACPE MOH Russia


A prospective, non-randomized study included 46 patients who underwent intraoperative assessment of the vegetative nervous system. Topical anesthesia was performed according to the following procedure. Direct preoperative preparation included instillations of a local anesthetic 0.5% solution of proximethacaine two or three times for 30 minutes before surgery (at an interval of 5-10 minutes), instillation of mydriatics.


In all patients, the peak fluctuations in intensity of vegetative nervous system were noted. The maximum stresses of the vegetative system were noted at the stages of hydrodissection and placing of the IOL, which may be due to water blow on reflexogenic zone of the iris, due to bolus injection of solution, viscoelastic and IOL. The maximum increase in 2,2 times from the initial value of index of vegetative system stress was observed at the time of placing iris retractors. The greatest traumatization of reflexogenic zones led to development of changes in hemodynamics requiring medical correction in several cases.


Intraoperative monitoring of the vegetative nervous system allows objectifying the severity of operational stress and thereby improving the patient's safety by taking timely measures to optimize anesthesia.

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