It is Just an Eye Case! Delayed Awakening After Retro-Bulbar Block

Abstract

Case ReportWe report a case of delayed awakening in a woman scheduled to have Pars Plana Vitrectomy in our outpatient surgi-center. She was sedated with 100 mg IV Propofol followed by a retrobulbar block with 6 ml of local anesthetic (mixture of 3 ml of 4% Lidocaine and 2.5 ml of 0.75% Bupivacaine, 0.5 ml of Hyaluronidase) and became apneic 5 min later. She stayed unconscious for half an hour in the or with a HR of 44-50/ min. She was transferred to PACU where she was restless and confused for few hours. She was stable hemodyamically after brief bradycardia that responded to atropine 1 mg, but she remained unconscious and did not respond to deep stimulus for about 25 min after the block. We suspect that she had intrathecal injection of local anesthetic.