The effect of peribulbar block with ropivacaine on bi‐hemispheric cerebral oxygen saturation in aged patients

Abstract

SummaryWe evaluated the effects of peribulbar block for eye surgery on bi-hemispheric regional cerebral oxygenation (rSO 2 ) of aged patients. In 66 adult patients, peribulbar block was performed using ropivacaine 10 mg.ml )1 with hyaluronidase 100 IU.ml. Cerebral oxygenation was monitored using continuous non-invasive, near-infrared spectroscopy. The rSO 2 data on the side where the eye block was performed were evaluated as eye block side values, whereas the data recorded on the other side were taken as control values. Mean rSO 2 values on the side where regional block was performed were not significantly different from control values (p > 0.05). Nevertheless, in several patients, a slight desaturation in the cerebral hemisphere on the block side was detected. Therefore, in aged patients, peribulbar block with ropivacaine does not significantly modify bi-hemispheric rSO 2 , but rSO 2 monitoring during peribulbar block should be a field of future research in aged patients with brain injury or disease.

Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

“…Minor reduction in rScO 2 is observed immediately after peribulbar block for eye surgery (Fodale et al, 2006) and with MAP reduced to 60 mmHg during orthognathic surgery rScO 2 decreases 5% (Choi et al, 2008). Such changes do not provoke postoperative cognitive dysfunction (POCD) as determined by a decrease in the minimal mental state examination (MMSE) score =2 points from baseline (Choi et al, 2008).…”

Neuro-Ophthalmological Emergencies. Are They Always Innocent? A Case Report and a Literature Review

“…In CNS, the amygdala is thought to be the site of action of local anesthetic drugs, since seizures are not observed in animals from which the amygdala has been experimentally removed [18]. Obviously, there is a continuum of sequelae, depending on the amount of drug reaching the CNS and the specific area of the brain to which the drug spreads [21].…”

“…In one-fifth of patients, an abrupt mean decrease in regional cerebral oxygenation (rSO2) has been observed on the side where the block was performed, 3-5 min subsequent to anesthetic injection, followed by a return toward baseline values 15 min following ropivacaine administration [21]. It is well known that neural cells are extremely sensitive to oxygen deprivation and seizures can be the result of acute hypoxia.…”