Regional Anesthesia for Eye Surgery

Ripart, Jacques; Nouvellon, Emmanuel; Chaumeron, Arnaud

doi:10.1097/00115550-200501000-00009

Cited by 24 publications

(16 citation statements)

References 64 publications

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“…These hypothetical examples highlight the importance of considering skull morphometrics rather than BW, because dogs gain body fat without considerable changes of skull size or skull shape. The same occurs in humans, as observed by Ripart et al . If this method is suitable to estimate total volume of local anesthetic solution for dogs with normal body condition scores as observed in this research, it might be better for thin or obese dogs.…”

Section: Discussionsupporting

confidence: 79%

“…All these observations contrast significantly with each other and with the volume used for intraconal blocks performed in human beings, cited by Ripart et al, where a total volume from 3 to 5 mL is usually recommended for intraconal blocks, regardless of the patient's BW. Even though there are obvious differences of BW among human patients, there is no great craniofacial diversity, and such BW differences seem not to influence the intraconal block procedure with a practically fixed dose.…”

Section: Discussioncontrasting

confidence: 59%

“…Considering these particularities, the more relevant anatomical structure in the canine retrobulbar space is the periorbita, which delimits the intraconal and extraconal spaces, whereas in the retrobulbar space of human beings, the periorbita is completely attached to the osseous structures of the skull, with minimal extraconal space compared to the canine orbit. In human beings, the periorbita and the periosteum of the bony orbit are one and the same, as the extraocular muscles have direct anatomical contact with the periosteum of the bony orbit walls, which makes the extraconal space in the retrobulbar space only a potential space . The anatomical variations of the canine orbit could explain the reason for such a large range of recommended volumes to be injected in the intraconal or extraconal spaces to provide regional ocular anesthesia .…”

Section: Discussionmentioning

confidence: 99%

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A morphometric study of the canine skull and periorbita and its implications for regional ocular anesthesia

Klaumann

Moreno

Montiani‐Ferreira

2017

Veterinary Ophthalmology

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Objective A hypothetical relationship between canine cranial length and the length of the periorbita could be used for intraconal anesthetic volume estimation. Study subjects Forty-one canine cadaver heads and one macerated dog skull. Procedures Inion and nasion points were recognized in the macerated skull and used as landmarks for cranial length measure. Thirty cadavers classified as dolichocephalic, mesaticephalic and brachycephalic were distributed in three study groups. Anatomic references of the skull shapes were recognized and parameters measured: body weight (BW), cranial length (L cr ) and length of the periorbita (L po ). Results were compared and statistical analyses were performed to find correlations between BW and the skull parameters. Contrast medium was injected in another 11 cadavers with a total volume calculated based on L cr (10 cadavers) or BW (one cadaver) and then submitted to computerized tomography examination to compare techniques, estimate the capacity of the intraconal space of the periorbita and to illustrate practical implications. Results There is a positive correlation between BW and L po (P < 0.001) as well as between L cr and L po (P < 0.0001). Linear regression of the variable BW predicts only 71% of the variable L po (r 2 = 0.71), whereas the variable L cr predicts 88% (r 2 = 0.88)Conclusions This study demonstrated a mathematical relation between L cr and L po . A method for calculating anesthetic solution volumes based on canine morphometric features is presented. The formula 0.1 mL/cm L cr to calculate total intraconal anesthetic volume is suggested.

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Section: Discussionsupporting

confidence: 79%

Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A morphometric study of the canine skull and periorbita and its implications for regional ocular anesthesia

Klaumann

Moreno

Montiani‐Ferreira

2017

Veterinary Ophthalmology

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“…Diperlukan volume obat anestesi lokal yang cukup besar agar distribusi obat dapat mencapai seluruh jaringan adiposa dan juga ruang intrakonal. 11 Terdapat struktur utama (pembuluh darah dan nervus optikus) yang terletak di dalam ruang intrakonal, sehingga rentan terhadap risiko cedera jarum, termasuk nervus optikus dengan selaput meningeal, sebagian besar arteri, dan persarafan autonom, sensorik, dan motorik bola mata. 11 Beberapa penulis mengusulkan untuk menghindari penempatan jarum pada ruang intrakonal (retrobulbar) dan lebih memilih untuk menempatkan jarum pada ruang ekstrakonal (peribulbar), teknik ini secara teori memiliki risiko yang lebih rendah.…”

Section: Diskusi Kasusunclassified

Laporan Kasus: Anestesi Blok Peribulbar pada Pasien dengan Gagal Jantung Kongestif yang Dilakukan Enukleasi

Adli¹,

Wullur²

2019

jap

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Seorang pria berusia 73 tahun datang ke Instalasi Gawat Darurat Pusat Mata Nasional Rumah Sakit Mata Cicendo pada bulan November 2018 dengan keluhan nyeri mata yang mengeluarkan darah dan disertai dengan keluhan sesak. Pemeriksaan mata menunjukkan prolaps okuli dan direncanakan untuk dilakukan enukleasi. Ahli kardiologi mendiagnosis sebagai hypertensive heart disease, congestive heart failure functional class IV, moderate mitral regurgitation, moderate aortic regurgitation. Laporan kasus ini bertujuan memaparkan keberhasilan tata laksana anestesi pada pasien usia lanjut dengan gagal jantung kongestif yang dilakukan enukleasi dalam blok peribulbar. Teknik blok peribulbar dipilih agar tidak memperberat masalah kardiovaskular serta untuk meminimalisir depresi kardiak. Teknik ini dilakukan dengan menyuntikkan obat anestesi lokal levobupivakain 0,5% pada inferotemporal, medial kantus, dan superonasal. Operasi berlangsung tanpa keluhan nyeri dan fluktuasi hemodinamik yang signifikan. Pascaoperasi pasien sadar penuh dengan skala nyeri NRS 60 menit pascaoperasi 0. Hal ini menunjukkan bahwa teknik anestesi blok peribulbar memberikan hasil memuaskan pada tindakan enukleasi. Enucleation under Peribulbar Block Anesthesia in Patients with Congestive Heart Failure: A Case ReportA 73-year-old male patient was presented to the emergency department of the National Eye Center Cicendo Hospital with a painful and bloody eye as well as shortness of breath. Eye examination revealed ocular prolapse and patient was scheduled for enucleation. The cardiologist diagnosed the patient with hypertensive heart disease, congestive heart failure functional class IV, moderate mitral regurgitation, and moderate aortic regurgitation. Patient then underwent treatment for six days. This case report aimed to describe the successful management of anesthesia in elderly patients with congestive heart failure who underwent peribulbar block for enucleation procedure. To prevent further cardiac problems and to minimize the risk of cardiac depression in this patient, the anesthetic technique chosen was peribulbar block with the injection of local anesthetic drug levobupivacaine 0.5% at the inferotemporal, medial canthus, and superonasal. The surgary took place without complaints of intraoperative pain and without significant hemodynamic fluctuations. Postoperatively, the patient was fully conscious and sixty minutes postoperative pain scale (Numeric Rating Scale) in this patient was 0. This shows that the peribulbar block anesthesia technique can provide satisfactory results for enucleation procedure.

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“…15-30 U per mL is commonly added to the local anaesthetic solution but some authors advocate using as low as 1 U/mL in order to reduce the cost (Fanning, 2006). Within reason the more given the better the effects, though manufacture from animal sources gives rise to concerns about the possibility of non-infectious encephalopathy (Ripart et al, 2005). Epinephrine use is controversial.…”

Section: Local Anaesthetics and Adjuvantsmentioning

confidence: 99%

Anaesthetic Management in Cataract Surgery

Apan¹

2013

Cataract Surgery

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Regional Anesthesia for Eye Surgery

Cited by 24 publications

References 64 publications

A morphometric study of the canine skull and periorbita and its implications for regional ocular anesthesia

A morphometric study of the canine skull and periorbita and its implications for regional ocular anesthesia

Laporan Kasus: Anestesi Blok Peribulbar pada Pasien dengan Gagal Jantung Kongestif yang Dilakukan Enukleasi

Anaesthetic Management in Cataract Surgery

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