Anestesia do tronco encefálico após bloqueio retrobulbar extraconal: é possível evitar? Relato de caso

Carneiro, Haroldo Maciel; Oliveira, Bruno Samuel Fraiman de; Ávila, Marcos Pereira de; Neto, Onofre Alves

doi:10.1590/s0034-70942007000400006

Cited by 10 publications

(6 citation statements)

References 5 publications

(12 reference statements)

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“…Therefore, in addition to appropriate monitoring, is it recommended that aspiration be done before every injection, that the eye be in neutral position during injection, that shorter needles be used, and that methods such as ultrasound be used to help determine the injection site when applying local anesthesia. 16 Regarding how to prevent LATS, the participants in our study gave more priority to monitorization and use of appropriate doses of local anesthetics rather than methods such as aspiration test and intermittent injection which indicate improper intra-arterial injection technique.…”

Section: Discussionmentioning

confidence: 88%

“…In particular, apnea or cardiac manifestations occur within seconds with intraarterial injections, while these findings appear more slowly with intrameningeal spread, over the course of minutes. 16 A large study of retrobulbar block including 6,000 patients showed that symptoms appeared after 2-40 min (mean 8 min) due to probable meningeal spread of local anesthetic to the CNS.13 In contrast, Dettoraki et al 17 reported a case receiving retrobulbar block for vitrectomy in which convulsions and contralateral hemiparesis occurred immediately after local anesthetic was administered due to intraarterial injection.…”

Section: Discussionmentioning

confidence: 99%

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The Knowledge of Eye Physicians on Local Anesthetic Toxicity and Intravenous Lipid Treatment: Questionnaire Study

Urfalıoğlu¹,

Urfalioglu²,

Öksüz³

2017

tjo

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Objectives:To evaluate the knowledge of ophthalmologists regarding local anesthesia toxicity syndrome (LATS) and intravenous lipid emulsion used in treatment, and to raise awareness of this issue.Materials and Methods:A questionnaire comprising 14 questions about demographics, local anesthesia (LA) use, toxicity, and treatment methods was administered to ophthalmologists at different hospitals.Results:The study included 104 ophthalmologists (25% residents, 67.3% specialists, 7.7% faculty members) with a mean age of 35.71±6.53 years. The highest number of participants was from state hospitals (65.4%), and 34.6% of the physicians had been working in ophthalmology for more than 10 years. Seventy-six percent of the participants reported using LA every day or more than twice a week, but 56.7% had received no specific training on this subject. No statistically significant difference was observed between different education levels and the rates of training (p=0.419). Bupivacaine was the most preferred LA and the majority of respondents (97.1%) did not use a test dose. Allergy (76%) and hypotension (68.3%) were the most common responses for early findings of LATS, while cardiac arrest (57.4%) and hepatotoxicity (56.4%) were given for late findings. The most common responses concerning the prevention of LATS included monitorization (72.4%) and use of appropriate doses (58.2%). Symptomatic treatment was selected by 72.4% of respondents and cardiopulmonary resuscitation and antihistamine treatment by 58.8%. Of the ophthalmologists in the study, 62.5% had never encountered LATS. The use of 20% intravenous lipid emulsion therapy for toxicity was known by 65% of the physicians, but only 1 participant stated having used it previously.Conclusion:The importance of using 20% lipid emulsion in LATS treatment and having it available where LA is administered must be emphasized, and there should be compulsory training programs for ophthalmologists on this subject.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

The Knowledge of Eye Physicians on Local Anesthetic Toxicity and Intravenous Lipid Treatment: Questionnaire Study

Urfalıoğlu¹,

Urfalioglu²,

Öksüz³

2017

tjo

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“…It has been suggested that one cannot be completely certain that the blockade is really intra- or extraconal (20). There are reports of brainstem anesthesia following PBA (21–23), including patients who required tracheal intubation and mechanical ventilation (25). A Cochrane systematic review of RBA versus PBA for cataract surgery also concluded that there is little to choose between the two in terms of anesthesia and akinesia during surgery, measuring acceptability to patients, need for additional injections and development of severe complications (25).…”

Section: Discussionmentioning

confidence: 99%

Brainstem Anesthesia after Retrobulbar Block: A Case Report and Review of Literature

Tolesa

Gebreal

2016

Ethiop J Health Sci

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“…A órbita óssea é preenchida pelo bulbo ocular (Figura 1), constituída por trabéculas ósseas que servem de proteção para o globo ocular e preenchida por tecido adiposo, onde são mantidas as maiorias das componentes oculares (SISSON; GROSSMAN, 2008;CARNEIRO et al 2007;KONIG;LIEBICH, 2011). Possui a função de separar o bulbo da cavidade craniana, onde existe a comunicação de nervos, artérias e veias do bulbo ocular através dos forames alares, etmoidais, ópticos, supraorbitares e rotundos (GELATT, 2003).…”

Section: Anatomia Do Bulbo Ocularunclassified

“…A utilização de agulhas hipodérmicas curtas para o bloqueio retrobulbar reduz a probabilidade de atingir os anexos ao bulbo ocular. Tem sido utilizada a agulha de 25 cm de comprimento por 0,7 mm de diâmetro (CARNEIRO et al, 2007). A dose utilizada da levobupivacaína 0,5 % em cirurgias oftálmicas em humanos é de 5 a 15 ml, de 37,5 a 112,5 mg do princípio, com bloqueio motor variando de moderado a completo (NOVABUPI, 2011).…”

Section: Bloqueio Retrobulbarunclassified

Bloqueio retrobulbar com levobupivacaína e lidocaína em gatos

Xavier¹

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Objetivo desta pesquisa foi avaliar os efeitos da anestesia retrobulbar em gatos com cloridrato de levobupivacaína 0,5% e cloridrato de lidocaína 2%, sem vasoconstritor. Quatorze gatos foram separados em dois grupos e submetidos à medicação pré-anestésica com maleato de acepromazina e posterior anestesia com propofol. Realizou-se bloqueio retrobulbar no canto medial das pálpebras do bulbo ocular direito com cloridrato de levobupivacaína 0,5% (Grupo I) e lidocaína 2% (Grupo II), sem vasoconstritor. Avaliou-se os momentos M 0 : seis horas antes da MPA, M 1 : 15 minutos após a MPA, quando foi feita a administração do anestésico.

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Anestesia do tronco encefálico após bloqueio retrobulbar extraconal: é possível evitar? Relato de caso

Cited by 10 publications

References 5 publications

The Knowledge of Eye Physicians on Local Anesthetic Toxicity and Intravenous Lipid Treatment: Questionnaire Study

The Knowledge of Eye Physicians on Local Anesthetic Toxicity and Intravenous Lipid Treatment: Questionnaire Study

Brainstem Anesthesia after Retrobulbar Block: A Case Report and Review of Literature

Bloqueio retrobulbar com levobupivacaína e lidocaína em gatos

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