Cardiopulmonary Arrest after Retrobular Block

Rosenblatt, Richard M.; May, Donald R.; Barsoumian, Krikor

doi:10.1016/s0002-9394(14)74932-3

Cited by 102 publications

(16 citation statements)

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“…Direct injection into the oph¬ thalmic artery with retrograde flow is believed to be the mechanism causing cardiopulmonary arrest after retro¬ bulbar anesthesia. 12 well as direct penetration of the globe in high myopes715 would be entirely eliminated with the use of the periocular injection described in this study. With the use of the 1.6-cm needle, it is not possible to enter the muscle cone and potentially damage any of the structures within the cone.…”

Section: Resultsmentioning

confidence: 92%

A Comparison of Retrobulbar and Periocular Anesthesia for Cataract Surgery

Weiss¹

1989

Arch Ophthalmol

124

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Section: Resultsmentioning

confidence: 92%

A Comparison of Retrobulbar and Periocular Anesthesia for Cataract Surgery

Weiss¹

1989

Arch Ophthalmol

124

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“…Today, local anesthesia is being used for most of vitreoretinal surgical procedures. As known, many complications have been reported with injection anesthesia, including globe perforation [14–16], injury to optic nerve [17], cranial nerve palsies [18], restrictive strabismus [19], diplopia [20], ptosis [21], retinal vein and artery occlusion [22, 23], and seizures and cardiorespiratory arrest [24, 25]. Mahajan et al reported that injection delivered in wrong plane can present as significant conjunctival chemosis, which ultimately hinders conjunctival displacement and later conjunctival migration for sutureless port closure [13].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Topical or Retrobulbar Anesthesia for 23-Gauge Posterior Vitrectomy

Çeliker

Karabaş

Şahin

2014

Journal of Ophthalmology

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Background. To compare the efficacy and safety of topical anesthesia versus retrobulbar anesthesia in 23-gauge vitreoretinal surgery. Materials and Methods. A total of 63 patients scheduled for 23 G posterior vitrectomy without scleral buckling procedures were included in the study. The patients were randomly assigned to receive either topical (Group 1, n = 31) or retrobulbar anesthesia (Group 2, n = 32). Postoperatively, patients were shown a visual analogue pain scale (VAPS) from 1 (no pain or discomfort) to 4 (severe pain or discomfort) to rate the levels of pain. Results. There was more discomfort in patients in Group 2 while anesthetic was administered (Group 1: 1.0 ± 0, Group 2: 2.3 ± 0.7, P = 0.0001). Between the two groups the level of pain during surgery (Group 1: 1.4 ± 0.5, Group 2: 1.5 ± 0.5; P = 0.85) was noted. There was also no significant difference between two groups postoperatively (Group 1: 1.2 ± 0.4, Group 2: 1.3 ± 0.4; P = 0.28). There were no complications in either group related to the anesthetic technique. No patient needed sedation or anesthesia supplement during the surgery or postoperative period. Conclusion. Topical anesthesia in posterior vitrectomy procedures is an effective and safe method that is alternative to retrobulbar anesthesia.

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“…Clinical signs have rapid onset and can range from loss of consciousness to cardiac arrest. Convulsions may be present or replaced by an electric silence [17]. …”

Section: Discussionmentioning

confidence: 99%

Convulsions during cataract surgery under peribulbar anesthesia: a case report

et al. 2014

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IntroductionLocoregional anesthesia techniques are increasingly used for cataract surgery. From these techniques, peribulbar anesthesia has been very successful over the retrobulbar anesthesia seen its effectiveness and safety. However, peribulbar anesthesia is not without risk.Case presentationA 70-year-old African man was scheduled for cataract surgery and lens implant for his right eye. His medical history included hypertension, diabetes mellitus and gall bladder surgery. There were no personal or family antecedents of allergy, epilepsy or taking food or toxic drug. No abnormalities were detected in his preoperative evaluation. In the operating room, standard monitoring was installed and a peripheral venous catheter 18g was inserted. Peribulbar anesthesia was realized with two injections in primary gaze position. The anesthetic mixture contained lidocaine 2% and bupivacaine 0.5%. The needle used was 25GA, 19mm, ¾ inch. The first injection was performed in his lower temporal peribulbar space with 5mL of mixture; the second injection was performed with 3mL of mixture in his upper nasal peribulbar space. These injections were performed after a negative aspiration test and followed by manual compression of his globe for 5 minutes. Five minutes after peribulbar anesthesia, his blood pressure increased to 209/115mmHg requiring three bolus of nicardipine (3.0mg) to reduce his blood pressure to 134/56mmHg. One minute after, he had generalized tonic–clonic seizures. Tracheal intubation was performed. His capillary blood glucose was 170mg/dL, axillary temperature was 36.5°C, and his serum electrolytes were normal. He recovered spontaneous ventilation 1.5 hours later. A neurological examination noted no deficit. Extubation was performed 15 minutes later without incident. A brain computed tomography and electroencephalogram were unremarkable. He was discharged on the second day and operated on 1 month later under general anesthesia.ConclusionsVarious serious complications can occur during locoregional anesthesia techniques in ophthalmic surgery. The mastering and perfecting of these techniques by practitioners and compliance with safety standards in anesthesia are the only way to guarantee the prevention of such complications.

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Cardiopulmonary Arrest after Retrobular Block

Cited by 102 publications

References 1 publication

A Comparison of Retrobulbar and Periocular Anesthesia for Cataract Surgery

A Comparison of Retrobulbar and Periocular Anesthesia for Cataract Surgery

A Comparison of Topical or Retrobulbar Anesthesia for 23-Gauge Posterior Vitrectomy

Convulsions during cataract surgery under peribulbar anesthesia: a case report

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