Anesthesia injury can come in a number of different forms. One of those forms of injury is postoperative visual loss (POVL). The most common cause of POVL is a decrease in blood and oxygen getting to the optic nerve which provides sight. The duty to provide this proper circulation rests with the anesthesiologist and the failure to provide that may be medical malpractice.
Oxygen is carried from the lungs to the rest of body by means of blood. It is the hemoglobin in the red blood cells that actually transmits the oxygen. The level of oxygen in the blood is determined by the percentage of red blood cells present in the blood stream. This is called the hematocrit. When a patient looses blood during the course of surgery sometimes non-blood products are used to maintain the patient’s blood pressure. This dilution of the blood results in the hematocrit going down and as a result the blood’s ability to carry oxygen is reduced.
During many surgical procedures the patient’s head is placed below the level of the heart for a long time to facilitate access. Tissue pressure from swelling during the course of the procedure can make it more difficult for the heart to pump blood to the head which is where the optic nerves are.
In those instances where a patient has POVL the primary factor to be looked for is whether or not the patient went through a surgery in the prone position that lasted six hours or more with blood loss of at least one liter. The issues of hematocrit level, dilution of the blood, blood and tissue pressure during the course of the surgery and patient positioning all have a significant effect on the ability of the heart to pump adequate blood and oxygen to the area of the optic nerve to make sure that body part is properly oxygenated. If that does not occur, then the patient may suffer POVL.
See anesthesia in children and other articles on anesthesia on this site.
