Term 3 Week 8 (w/c 18/06/12)
To start this week we would like to know how many different complications can be named related to local anaesthesia for ophthalmic surgery.
List complications of eye blocks!
Please take turns and list one complication per tweet. This will encourage new members. Feel free to DM the team if you want us to add your complication anonymously.
Thanks for all of the complications yesterday, both major and minor.
You are allocated to ophthalmology. The first patient on the list is a 69 year old male listed for a vitrectomy.
What features are you looking for that will influence your choice of anaesthesia?
There are many features in ophthalmology that should be taken into account selecting anaesthesia for longer procedures. Local anaesthesia may indeed be suitable.
The 69 year old male listed for vitrectomy has had a preoperative visit to the nurse led clinic because the surgeon has requested that GA is the most suitable choice! The nurses has taken an ECG and it shows a new diagnosis that the patient is in AF with a ventricular rate of 115.
What actions will you take concerning the rhythm and rate?
The final part of the jigsaw is as follows. The 69 year old male has Parkinson’s which makes lying still for a prolonged period an impossibility. His macula is off which constitutes an ocular emergency. They want to proceed on the urgent Vitreo Retinal list tomorrow afternoon under General Anaesthesia. He is asymptomatic beyond his Parkinson’s and the AF is definitely a new diagnosis. The GP says that an ECG performed 4 years ago was in sinus rhythm. There has been no indication to repeat an ECG since then.
Have you a clear plan? Does this change what you are thinking?
There are no trick questions in #gasclass. It is an educational tool only. Everyone’s opinion is as valid as the next person. Follow the conversation by using (or searching for) the hashtag #gasclass on twitter. We welcome input from all specialities and you can send us a direct message if you would prefer to remain anonymous.