Brainstem Anesthesia after Retrobulbar Anesthesia in Cataract Surgery: A Case Report

Abstract

Brain-stem anesthesia is a serious and rare complication of orbital regional anesthesia that may occur when the local anesthetic agent gains access to the central nervous system via a direct spread from the apex of the orbit or the submeningeal pathways. We report the case of a 66 -year-old man who developed, after a retro-bulbar block for cataract surgery, a tonico-clonic seizures, hypotension and bradycardia-features of brainstem anesthesia. We present the clinical features, treatment and comments on how to prevent the problem. Although it is rare, and because it may be life-threatening in some cases, physicians who perform retrobulbar block should be aware of its features and various clinical manifestation in order to recognize and treat it. Also, facilities where ophtalmic surgery under local anesthesia are performed should be properly equiped in order to manage this complication.