Correspondence  |   September 2017
Dealing with Ophthalmic Chemosurgery Complications
Author Notes
  • Fondation Adolphe de Rothschild, Paris, France (M.-C.N.). mnghe@for.paris
  • (Accepted for publication June 1, 2017.)
    (Accepted for publication June 1, 2017.)×
Article Information
Correspondence
Correspondence   |   September 2017
Dealing with Ophthalmic Chemosurgery Complications
Anesthesiology 9 2017, Vol.127, 586-587. doi:10.1097/ALN.0000000000001762
Anesthesiology 9 2017, Vol.127, 586-587. doi:10.1097/ALN.0000000000001762
We read with great interest the review by Scharoun et al.1  in which the authors discuss anesthesia management for ophthalmic artery chemosurgery focusing on unexpected respiratory and cardiovascular complications. We address some issues.
The authors advocate systematic and early intravenous administration of epinephrine to treat any decrease in lung compliance, which is the main complication of this procedure. This therapeutic option is questionable. Admittedly, epinephrine dilates bronchial airways.2  However, the main action of this mixed α- and β-adrenergic receptor agonist is on the cardiovascular system, with vasoconstricting, chronotropic, and inotropic effects, also causing several side effects including arrhythmia and systemic hypertension. A decrease in lung compliance can often occur on its own, with neither bradycardia nor hypotension, so cardiovascular therapy is not required and should be used with caution.
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