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Relationship between anesthesia and postoperative endophthalmitis: A retrospective study.

Abstract Previous study showed that patients under general anesthesia (GA) had nasopharyngeal secretions on the face at the end of ocular surgery, especially in propofol-based total intravenous anesthesia (TIVA), it might induce postoperative endophthalmitis. Therefore, we conducted a retrospective study to compare the incidence of endophthalmitis after ocular surgery under topical, inhalation anesthesia, and propofol-based TIVA in our medical center from 2011 to 2015.A total of 21,032 patients were included, and we evaluated epidemiologic factors, systemic diseases, other ocular pathologic characteristics, complications during the surgery, technique of ocular surgery, method of antibiotic prophylaxis, vitreous culture, and vision outcome in these patients.Fifteen endophthalmitis cases among 21,032 operations reported, equaling an incidence of 0.071%. The incidence rates under topical, inhalation anesthesia, and propofol-based TIVA were 0.083%, 0.039%, and 0%, respectively (P = 0.39). Moreover, the risk of endophthalmitis under GA (0.024%) was significantly lower than topical anesthesia (0.083%) (P < 0.001). We also found that elder was the risk factor for endophthalmitis following ocular surgery.In conclusion, propofol-based TIVA or inhalation anesthesia did not increase the risk of endophthalmitis after ocular surgery. Thus, GA was not a risk factor for postoperative endophthalmitis. By contrast, elder was the risk factor for postoperative endophthalmitis.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28328861
OWN - NLM
STAT- MEDLINE
DA  - 20170322
DCOM- 20170410
LR  - 20170410
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 12
DP  - 2017 Mar
TI  - Relationship between anesthesia and postoperative endophthalmitis: A
      retrospective study.
PG  - e6455
LID - 10.1097/MD.0000000000006455 [doi]
AB  - Previous study showed that patients under general anesthesia (GA) had
      nasopharyngeal secretions on the face at the end of ocular surgery, especially in
      propofol-based total intravenous anesthesia (TIVA), it might induce postoperative
      endophthalmitis. Therefore, we conducted a retrospective study to compare the
      incidence of endophthalmitis after ocular surgery under topical, inhalation
      anesthesia, and propofol-based TIVA in our medical center from 2011 to 2015.A
      total of 21,032 patients were included, and we evaluated epidemiologic factors,
      systemic diseases, other ocular pathologic characteristics, complications during 
      the surgery, technique of ocular surgery, method of antibiotic prophylaxis,
      vitreous culture, and vision outcome in these patients.Fifteen endophthalmitis
      cases among 21,032 operations reported, equaling an incidence of 0.071%. The
      incidence rates under topical, inhalation anesthesia, and propofol-based TIVA
      were 0.083%, 0.039%, and 0%, respectively (P = 0.39). Moreover, the risk of
      endophthalmitis under GA (0.024%) was significantly lower than topical anesthesia
      (0.083%) (P &lt; 0.001). We also found that elder was the risk factor for
      endophthalmitis following ocular surgery.In conclusion, propofol-based TIVA or
      inhalation anesthesia did not increase the risk of endophthalmitis after ocular
      surgery. Thus, GA was not a risk factor for postoperative endophthalmitis. By
      contrast, elder was the risk factor for postoperative endophthalmitis.
FAU - Lai, Hou-Chuan
AU  - Lai HC
AD  - aDepartment of Anesthesiology, Tri-Service General Hospital and National Defense 
      Medical Center, Taipei, Taiwan, Republic of China bDepartment of Ophthalmology,
      Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan,
      Republic of China cDepartment of Anesthesiology, Cathay General Hospital, Taipei,
      Taiwan, Republic of China.
FAU - Tseng, Wei-Cheng
AU  - Tseng WC
FAU - Pao, Shu-I
AU  - Pao SI
FAU - Wong, Chih-Shung
AU  - Wong CS
FAU - Huang, Ren-Chih
AU  - Huang RC
FAU - Chan, Wei-Hung
AU  - Chan WH
FAU - Wu, Zhi-Fu
AU  - Wu ZF
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anesthetics, Local)
RN  - YI7VU623SF (Propofol)
SB  - AIM
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Anesthesia/*adverse effects/*methods
MH  - Anesthesia, Inhalation/adverse effects/methods
MH  - Anesthesia, Intravenous/adverse effects/methods
MH  - Anesthetics, Local/administration &amp; dosage/adverse effects
MH  - Antibiotic Prophylaxis
MH  - Endophthalmitis/complications/*etiology
MH  - Eye Infections/complications
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Ophthalmologic Surgical Procedures/*adverse effects/*methods
MH  - Postoperative Complications/epidemiology
MH  - Propofol/administration &amp; dosage
MH  - Retrospective Studies
MH  - Visual Acuity
PMC - PMC5371498
EDAT- 2017/03/23 06:00
MHDA- 2017/04/11 06:00
CRDT- 2017/03/23 06:00
AID - 10.1097/MD.0000000000006455 [doi]
AID - 00005792-201703240-00064 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Mar;96(12):e6455. doi: 10.1097/MD.0000000000006455.

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