Anesthesia management for children with eye injuries

Eye injuries in childhood are very common and an important cause of ocular morbidity. They are a leading cause of non-congenital unilateral blindness in children.The anesthesia management of children with eye injuries requires particular skills and is a challange for all anesthesiologists. The anesthesia management must prove safety for the child, but also must not endanger eye injury any further. In the politraumatized child, trauma principlesmust allways be applied. Life-threatening problems should be managed before sight-threatening problems. General anesthesia is a choice for majority of child en with an eye injury.Maintenance of anesthesia will depend on patient factors, local facilities and surgeon preferences. Extubation is better to be performed in deep anesthesia, breathing spontaneously, lying on the side to avoid coughing and straining as this increase the risk of ocular hemorrhage. Multimodal approach and combination therapy (e.g. dexamethason and ondasteron) will minimize PONV in children. Satisfactory postoperative analgesia is important to have a non-crying and calm child to avoid rise in IOP and postoperative hemorrhage