This is the current release of the guideline.

A summary of the Practice Advisory is presented below:

• There is a subset of patients who undergo spine procedures while they are positioned prone and receiving general anesthesia that has an increased risk for development of perioperative visual loss.  This subset includes patients who are anticipated preoperatively to undergo procedures that are prolonged, have substantial blood loss, or both (high-risk patients).
• Consider informing high-risk patients that there is a small, unpredictable risk of perioperative visual loss.
• The use of deliberate hypotensive techniques during spine surgery has not been shown to be associated with the development of perioperative visual loss.
• Colloids should be used along with crystalloids to maintain intravascular volume in patients who have substantial blood loss.
• At this time, there is no apparent transfusion threshold that would eliminate the risk of perioperative visual loss related to anemia.
• High-risk patients should be positioned so that their heads are level with or higher than the heart when possible. In addition, their heads should be maintained in a neutral forward position (e.g., without significant neck flexion, extension, lateral flexion, or rotation) when possible.
• Consideration should be given to the use of staged spine procedures in high-risk patients.

None provided

The advisory statements contained in this document represent a consensus of the current spectrum of clinical opinion and literature-based findings.

Not applicable: The guideline was not adapted from another source.

2006 Jun

American Society of Anesthesiologists - Medical Specialty Society

American Society of Anesthesiologists

Task Force on Perioperative Blindness

Task Force Members: Mark A. Warner, M.D. (Chair), Rochester, Minnesota; James F. Arens, M.D., Houston, Texas; Richard T. Connis, Ph.D., Woodinville, Washington; Karen B. Domino, M.D., Seattle, Washington; Lorri A. Lee, M.D., Seattle, Washington; Neil Miller, M.D., Baltimore, Maryland; Sohail Mirza, M.D., Seattle, Washington; Nancy Newman, M.D., Atlanta, Georgia; David G. Nickinovich, Ph.D., Bellevue, Washington; Steven Roth, M.D., Chicago, Illinois; Peter Savino, M.D., Philadelphia, Pennsylvania; Philip Weinstein, M.D., San Francisco, California

Not stated

This is the current release of the guideline.

None available

None available

This NGC summary was completed by ECRI on June 29, 2006. The information was verified by the guideline developer on July 5, 2006.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.