Anaes Vivas · Ophthalmic anaesthesia
Open-globe and penetrating eye injury anaesthesia — viva
Structured oral examination station for open-globe-penetrating-injury.
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ANZCAFRCAEDAICABAFCAI
Prompt
Registrar refuses suxamethonium "because open eye" and plans mask ventilation without plan for full stomach.
Opening
State the one-line answer first: correct the registrar — suxamethonium is not absolutely contraindicated when aspiration risk dominates; the brief roughly 10 mmHg rise is less dangerous than aspiration or bucking. Run a proper RSI.[1][3][4]
References4ShowHide
- [1]Vachon CA, Warner DO, Bacon DR Succinylcholine and the open globe. Tracing the teaching. Anesthesiology, 2003.PMID 12826863
- [2]Cunningham AJ, Barry P Intraocular pressure--physiology and implications for anaesthetic management. Canadian Anaesthetists' Society journal, 1986.PMID 3516335
- [3]Kelly RE, Dinner M, Turner LS, et al. Succinylcholine increases intraocular pressure in the human eye with the extraocular muscles detached. Anesthesiology, 1993.PMID 8239012
- [4]McGoldrick KE The open globe: is an alternative to succinylcholine necessary? Journal of clinical anesthesia, 1993.PMID 8442960