Dacryocystorhinostomy (DCR)

Anesthesia Implications

Position: Supine, arms free at side, Bed turned 90 degrees
Time: 1-2 hours (average)
Blood Loss: Moderate (50 – 200 ml)
Post-op Pain: Moderate (3-6)
Maintenance Paralytic: No

Protect the airway – The surgeon will be working in the nasal passages, so there is significant risk for blood loss. This is one of the primary reasons to protect the airway with the ETT. Monitor the patient closely afterward for bleeding.

ETT side – make sure the tube is taped opposite to the operating side OR use an oral RAE

Extubate awake – to remove the risks of blood aspiration.

The nasolacrimal duct is obstructed – which is most often the result of chronic dacryocystitis. This procedure creates a fistula between the common canaliculus to the nasopharynx.

nasal packing, typically soaked in phenylephrine, 4% cocaine, and lidocaine will be applied at the end of the surgery.

This procedure differs from a Dacryocystoplasty in that a new passage is being made to drain the duct. In a dacryocystoplasty, the existing passage is opened and dilated with a balloon.