Ophthalmologic complications after administration of local anesthesia in dentistry: a systematic review

Alamanos, Christos; Raab, Philipp; Gamulescu, Andreea; Behr, Michaël

doi:10.1016/j.oooo.2015.10.023

Cited by 21 publications

(25 citation statements)

References 32 publications

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“…Local anesthetics can elicit ocular complications during dental procedures reaching eye socket via vascular, neurological and lymphatic pathways [11, 12]. Individual regional vascular-anatomical variations (anomalies) could predispose to such side effects [6]. In case of ocular local anesthesia, the affection way may be shorter and easier.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, local anesthetics are well tolerated, however, several serious adverse events, local or systemic, are reported. Overall, ocular complications are commonly rare and have been reported as transient vision loss or amaurosis [1–6], temporary paralysis of oculomotor muscles and cranial nerves III, IV and VI with diplopia [1, 6], mydriasis [1], Horner syndrome [1, 7], ptosis [8] and accommodation problems with both local ophthalmological and dental anesthesia. According to different authors and manifestation patterns, the prevalence after dental procedures is reported to be 1:1000 to 0,1% [1] or even 0,7% [9].…”

Section: Introductionmentioning

confidence: 99%

“…Several mechanisms and patterns as inadvertent intravascular injection or direct diffusion of local anesthetic solution to the eye socket after dental procedures as well as myotoxic effects are proposed [5, 6, 8]. By interaction with eye vegetative nervous system, local anesthetics could affect the nerve endings directly, promoting sympathetic or parasympathetic damaging patterns [1, 6]. Here, we present three cases with temporary amaurosis after subconjunctival application of mepivacaine 2% solution for laser cyclophotocoagulation (CPC) in patients with advanced refractory glaucoma.…”

Section: Introductionmentioning

confidence: 99%

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Ipsilateral transient amaurosis, mydriasis and light reflex absence after subconjunctival local anesthesia with mepivacaine in three patients with refractory glaucoma – a case report

et al. 2019

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Background The subconjunctival anesthesia with local anesthetics is considered as a low-risk procedure allowing ocular surgery without serious complications typical for retro- or parabulbar anesthesia, especially in patients with preexisting Optic Nerve damage. We report development of ipsilateral transient amaurosis accompanied with mydriasis and both, direct and consensual light response absence. Case presentation Three patients with advanced refractory glaucoma undergoing laser cyclophotocoagulation (CPC) for intraocular pressure lowering experienced these adverse effects just few minutes after subconjunctival injection of mepivacaine 2% solution (Scandicaine® 2%, without vasoconstrictor supplementation). The vision was completely recovered to usual values in up to 20 h after mepivacaine application. Extensive ophthalmological examination, including cranial magnetic resonance imaging (MRI), revealed no further ocular abnormalities, especially no vascular constriction or thrombotic signs as well as no retinal detachment. The oculomotor function remained intact. The blockade of ipsilateral ciliary ganglion parasympathetic fibers by mepivacaine may be the responsible mechanism. Systemic pathways as drug-drug interactions seem to be unlikely involved. Importantly, all three patients tolerated the same procedure previously or at a later date without any complication. Overall, our thoroughly elaborated risk management could not determine the causative factor explaining the observed ocular complications just in the current occasion and not at other time points. Conclusions Doctors should be aware and patients should be informed about such rare complications after subconjunctival local anesthetics administration. Adequate risk management should insure patients’ safety.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ipsilateral transient amaurosis, mydriasis and light reflex absence after subconjunctival local anesthesia with mepivacaine in three patients with refractory glaucoma – a case report

et al. 2019

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“…They found that the Gow-Gates technique for mandibular block anesthesia is only associated with diplopia, vision impairment is more associated with inferior alveolar nerve blocks than with posterior superior alveolar nerve blocks, and the latter technique has rarely been reported as a cause of amaurosis. Ocular complications in the literature are mostly with an injection of lidocaine [56].…”

Section: Ophthalmologic Complicationsmentioning

confidence: 99%

Complications Associated with Local Anesthesia in Oral and Maxillofacial Surgery

Yalcin¹

2020

Topics in Local Anesthetics

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One of the important attempts in clinical oral surgery practice is to maintain safe and effective local anesthesia. Dental procedures are frequently performed under local anesthesia; thus, drug-related complications are often encountered. It is mandatory to have a preoperative evaluation of the patient and choosing the proper local anesthetic agent. Various complications including hypersensitivity, allergy, overdosage, toxicity, hematoma, trismus, paresthesia, or neuralgia can be observed during practice. Therefore, the practitioner should be aware of the possible complications and management methods. The aim of this chapter is to review the preoperative and postoperative complications associated with the local anesthetic in oral and maxillofacial surgery practice. The prevention of measures and treatment of the complications is also emphasized.

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“…Az irodalom szerint a nők sokkal gyakrabban, 70-80%-ban érintettek [9,10,24]. Steenen felvetése szerint elképzelhető, hogy anatómiai különbségek vannak a nemek között ezen a területen [9].…”

Section: Megbeszélésunclassified

Átmeneti kettős látás és szemizombénulás fogászati érzéstelenítést követően

2018

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Dental anaesthesia is one of the most frequently performed medical procedures. Although the frequency of ocular complications is low, these can be alarming and can potentially give rise to medicolegal issues. Dentists and oral surgeons should be well-informed of these adverse reactions. Ophthalmologists and emergency physicians might be required for appropriate care of these patients. Fortunately, most ocular complications related to dental anesthesia are transient. Differential diagnosis includes stroke and intracranial hemorrhage and so vital signs are to be closely monitored. The planned surgical procedure can be carried out once the patient is fully informed and gave consent. The psychological aspect of such unexpected complication must be managed appropriately. We report a case with diplopia and ophthalmoplegia of a reversible and temporary nature. We also include a literature review of ophthalmologic complications after intraoral local anaesthesia in this paper. Orv Hetil. 2018; 159(52): 2212–2216.

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Ophthalmologic complications after administration of local anesthesia in dentistry: a systematic review

Cited by 21 publications

References 32 publications

Ipsilateral transient amaurosis, mydriasis and light reflex absence after subconjunctival local anesthesia with mepivacaine in three patients with refractory glaucoma – a case report

Ipsilateral transient amaurosis, mydriasis and light reflex absence after subconjunctival local anesthesia with mepivacaine in three patients with refractory glaucoma – a case report

Complications Associated with Local Anesthesia in Oral and Maxillofacial Surgery

Átmeneti kettős látás és szemizombénulás fogászati érzéstelenítést követően

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