EC Ophthalmology

Laser refractive surgery has gained popularity due to the ability to quickly and safely perform surgical correction of myopia, hyperopia and various forms of astigmatism. Local anesthetics effectively eliminate pain syndrome, but they cannot affect increased psychoemotional anxiety before surgery. Moderate sedation, anesthesia, stress-limiting effect and the possibility of maintaining the patient's consciousness and contact with him, make xenon an alternative to general anesthesia.

Our randomized study involved 2 groups: the main group (n = 29), in which xenon sedation was performed in sub-narcotic dosages; and the control group (n = 20), in which 25 mg hydroxyzine premedication was performed. Blood cortisol taken immediately before and immediately after surgery was measured in the laboratory. Capillary glucose levels were measured simultaneously with cortisol. To assess the stress level using the analysis of heart rate variability “varicard”, a stress index and an indicator of the activity of regulatory systems were used. Examination of patients using the “cardiovisor” device (Russia) allowed us to study vegetative reactions under stress, which manifest themselves primarily in the form of changes in cardiovascular parameters. The indices "myocardium" and "rhythm" characterize the total amount of variance deviations from the norm.

After xenon sedation, cortisol levels decreased after surgery (p = 0.02). In the main group, the activity index of regulatory systems decreased after xenon sedation (p = 0.003). In the control group, an increase in this indicator was noted (p = 0.002). The stress index decreased after xenon sedation (p < 0.01). And in the control group, the stress index increased (p < 0.01). The indices "myocardium" and "rhythm" also significantly decreased in the group with xenon sedation (p = 0.03) (p < 0.01), respectively, compared with the control group.

Conducting such preoperative preparation as xenon sedation guarantees the safe conduct of laser ophthalmological interventions in emotionally labile patients.

 Keywords: Sedation; Laser Refractive Interventions; Anxiety; Xenon

1. Gerasimova YY and Ermakov MA. “Neuroprotective effects subarcticus and drug concentrations medical xenon”. Vestnik SMUS18 (2017): 21-24.
2. Wu L., et al. “Lasting effects of general anesthetics on the brain in the young and elderly: "mixed picture" of neurotoxicity, neuroprotection and cognitive impairment”. Journal of Anesthesia 2 (2019): 321-335.
3. Myasnikova VV., et al. “Xenon laryngeal mask anesthesia in ophthalmosurgery”. Russian Journal of Anesthesiology and Reanimatology 4 (2018): 64-68.
4. GR Abuzarova., et al. “Double-blind, randomized, placebo-controlled study of Xenon in cancer pain therapy”. Annals of Critical Care 4 (2020): 48-57.
5. Potievskaya VI., et al. “Assessment of xenon effect on postoperative pain syndrome severity in oncological patients: a randomized study”. Annals of Critical Care 3 (2021): 140-150.
6. Ershov AV., et al. “The effect of xenon on the activity of glycogen synthase kinase-Зβ in the perifocal zone of ischemic cerebral infarction (Experimental study)”. General Reanimatology2 (2023): 60-67.
7. Lisichenko IA and Gusarov VG. “Choice of anesthesia for orthopedic surgery in elderly and senile patients (Review)”. General Reanimatology3 (2022): 45-58.
8. Myasnikova VV., et al. “Patient satisfaction with anesthesia during laser vision correction by the SMILE method”. Modern Problems of Science and Education 6 (2023).