Periocular local anesthesia: Medial orbital as an alternative to superior nasal injection

Hustead, Robert F.; Hamilton, Robert C.; Loken, R. G.

doi:10.1016/s0886-3350(13)80166-6

Cited by 43 publications

(10 citation statements)

References 17 publications

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“…When a vessel network passes through a pressure chamber, a Starling resistor effect may occur. 12 The outflow of aqueous from the eye is mainly determined by the pressure difference between the IOP and the episcleral venous pressure. As the aqueous moves through the trabecular mesh into Schlemm's canal through the sclera to episcleral veins the flow through the system is determined by the facility, C~b, of the system.…”

Section: Discussionmentioning

confidence: 99%

The electroretinogram during orbital compression following intraorbital regional block for cataract surgery

1994

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The electroretinogram (ERG) is a transient biopotential that reflects the electrical response of the distal retina to photostimulation. Disturbances in retinal circulation produce characteristic abnormalities in the ERG wave form. The objective of this study was to investigate the changes in the ERGThe electroretinogram (ERG), recorded from the cornea in response to brief flash stimulation~ has two primary components, the "a-wave" and "b-wave" (Figure 1) which appear to reflect synaptic and post-synaptic activity in the inner nuclear layer, distal to the ganglion cell body layer. Disturbances in retinal circulation produce revers-CAN J ANAESTH 1994 / 41: 9 / pp 802-6

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Section: Discussionmentioning

confidence: 99%

The electroretinogram during orbital compression following intraorbital regional block for cataract surgery

1994

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“…An alternative site of puncture for peribulbar anesthesia is the medial canthus (Fig 2). 19 The needle is introduced at the medial junction of the lids, nasal to the lacrimal caruncle, in a strictly posterior direction, to Յ15 mm depth. At this level, the space between the orbital wall and the globe is similar in size to the inferior and temporal approach and is free from blood vessels.…”

Section: Conventional Needle Blockmentioning

confidence: 99%

Regional anesthesia for eye surgery

Ripart

Nouvellon

Chaumeron

2005

Regional Anesthesia and Pain Medicine

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“…A preferable alternative to the latter site of injection is the fat compartment on the nasal side of the medial rectus muscle ( fig. 5) [13]. Access of local anaesthetics to the motor nerve supply of the superior oblique muscle and, by spread through the orbital septum, of the orbicularis muscle, are promoted [28].…”

Section: Pericone (Peribulbar Periocular) Blocksmentioning

confidence: 99%

Techniques of orbital regional anaesthesia

Hamilton¹

1995

British Journal of Anaesthesia

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Knowledge of the basic science disciplines (pharmacology of the ocular and local anaesthetic drugs, physiology of the eye, anatomy of the orbit and its contents) is essential for safe practice of orbital regional anaesthesia [10]. Observation of, and subsequent initial supervision by, personnel with wide clinical experience and knowledge is recommended. The goal for each practitioner is to build up an experiential database from which increasingly good judgement can result.The anaesthetist should have a good understanding of the operating ophthalmologist's preferred conditions for surgery. Anaesthesia requirements are dictated by the type and operative technique of the proposed surgery, the surgeon's particular preferences and the wishes of the patient. Current techniquesThe requirements for intraocular surgery using regional anaesthesia, as established in the 1950s and 1960s are threefold: globe and conjunctival anaesthesia; globe, lid and periorbital akinesia; and intraocular hypotonia. Desirable operating conditions are attainable safely using relatively large volumes of hyaluronidase-containing local anaesthetics injected appropriately within the orbit. Mechanical orbital decompression devices are used frequently for efficient production of globe hypotonia [3,6]. APPLIED ANATOMYA matrix of connective tissues, which supports and allows dynamic function of the orbital contents, also controls the mode of injectate spread [17]. Globe and conjunctival anaesthesia (conduction block of the intraorbital sensory divisions of the ophthalmic branch of the trigeminal nerve) are achieved more easily than globe akinesia (conduction block of intraorbital portions of the oculomotor cranial nerves III, IV and VI).The oculomotor nerves enter the muscle bellies of the four rectus muscles from their conal surface, %U -$QDHVWK ±

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Periocular local anesthesia: Medial orbital as an alternative to superior nasal injection

Cited by 43 publications

References 17 publications

The electroretinogram during orbital compression following intraorbital regional block for cataract surgery

The electroretinogram during orbital compression following intraorbital regional block for cataract surgery

Regional anesthesia for eye surgery

Techniques of orbital regional anaesthesia

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