Regional anesthesia of the eye, orbit, and periocular skin

Ascaso, Francisco J.; Peligero, Javier; Longás, Javier; Grzybowski, Andrzej

doi:10.1016/j.clindermatol.2014.10.014

Cited by 15 publications

(4 citation statements)

References 38 publications

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“…The addition of epinephrine (which serves as a vasoconstrictor) to lidocaine (1:100,000 or 1:200,000) prolongs the duration of action of the anesthetic. Lidocaine alone at a dose of 3-4 mg/kg and lidocaine with epinephrine at a dose of 7 mg/kg are considered safe [10].…”

Section: A B Cmentioning

confidence: 99%

Transient unilateral exotropia after an infraorbital local anesthetic injection: a case report

Choi¹,

Song²

2022

Arch Aesthetic Plast Surg

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We report a case of transient unilateral exotropia, a rare complication that occurred after an infraorbital local anesthetic injection, and present the possible mechanism underlying this adverse effect. A 64-year-old man underwent an excisional biopsy under local anesthesia for bilateral lower eyelid masses. He received a subcutaneous injection of a local anesthetic (a combination of 1:100,000 epinephrine and 2% lidocaine). Intraoperatively, we observed a homogeneous, fat-attenuated mass with thin fibrous septae inside the orbital septum of each eye. Following excision of the masses, the patient developed severe diplopia accompanied by exotropia, impaired adduction, and mydriasis of the right eye. The pupillary light reflex, visual acuity, and visual field test results were within normal ranges. Notably, his symptoms completely resolved 4 hours postoperatively without intervention. To our knowledge, transient unilateral exotropia following infraorbital local anesthetic injection is rare. The exotropia was attributed to diffusion of the epinephrine/lidocaine solution, which may have affected the ciliary ganglion and the medial rectus muscle. Caution is warranted during local anesthetic injections in patients who undergo periorbital surgery.

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Section: A B Cmentioning

confidence: 99%

Transient unilateral exotropia after an infraorbital local anesthetic injection: a case report

Choi¹,

Song²

2022

Arch Aesthetic Plast Surg

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“…Retrobulbar and peribulbar anesthesia have a major role in ophthalmic surgery due to their provision of excellent analgesia and akinesia. However, these procedures are associated with major complications [2-5], such as scleral perforation [6, 7], retrobulbar hemorrhage [8], optic injury [1, 9], globe ischemia [9], oculocardiac reflex [9] and brainstem anesthesia [10-14].…”

Section: Introductionmentioning

confidence: 99%

A New Two-Step Anesthesia for 23- or 25-Gauge Vitrectomy Surgery: A Prospective, Randomized Clinical Trial

et al. 2020

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Objective: To investigate the safety and efficacy of topical anesthesia combined with subconjunctival anesthesia (termed two-step anesthesia) for 23- or 25-gauge pars plana vitrectomy or other posterior segment surgery. Methods: Patients (n = 90) requiring 23-/25-gauge vitrectomy or other posterior segment surgery were randomized into 3 groups. Group 1 received peribulbar anesthesia, group 2 received retrobulbar anesthesia and group 3 received two-step anesthesia. A 5-point visual analog pain scale (VAPS) was used to measure self-report of patient pain. Complications were recorded for subsequent analysis. Results: VAPS scores for overall intraoperative pain ranged from 0 to 3 (1.07 ± 1.07) in group 1, from 0 to 2 (0.69 ± 0.93) in group 2 and from 0 to 3 (1.06 ± 0.98) in group 3. Assessment of surgeon discomfort score ranged from 0 to 2 (0.31 ± 0.66) in group 1, from 0 to 3 (0.38 ± 0.82) in group 2 and from 0 to 2 (0.47 ± 0.62) in group 3. Both scores reveal no significant difference among the 3 groups. While there were no complications noted in group 1, there was an ocular perforation in group 2. Additionally, there were no complications in group 3 related to the anesthetic technique. Conclusions: Results suggest that two-step anesthesia is a safe and effective anesthetic approach for selected patients undergoing 23- or 25-gauge pars plana vitrectomy or other posterior segment surgeries. It may offer a viable alternative to peribulbar anesthesia and retrobulbar anesthesia for carefully selected 23- or 25-gauge cannular-access ocular surgeries.

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“…P.Leão [1]. Peribulbar square will be safer in examination should retrobulbar square because of a lesseps frequency about genuine difficulties for example, brainstem anesthesia, globe perforation, and retrobulbar discharge [2] However, the improvement from claiming visual akinesia with peribulbar square takes longer time in examination will retrobulbar block, and the event from claiming insufficient absense of pain is Additionally more incessant Previously, peribulbar square [3]. The peribulbar square is a needle-based method that varies from the retrobulbar square As far as those profundity What's more angulation about needle placement inside the circle [2].…”

Section: Introductionmentioning

confidence: 99%

Evalution of the Effect of Addition of Magnesium Sulfate to Local Anesthetics for Peribulbar Block: a Meta-Analysis for Randomized Trials

Hamid

Khashaba

Aboelsaod

2020

Benha Journal of Applied Sciences

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Regional anesthesia of the eye, orbit, and periocular skin

Cited by 15 publications

References 38 publications

Transient unilateral exotropia after an infraorbital local anesthetic injection: a case report

Transient unilateral exotropia after an infraorbital local anesthetic injection: a case report

A New Two-Step Anesthesia for 23- or 25-Gauge Vitrectomy Surgery: A Prospective, Randomized Clinical Trial

Evalution of the Effect of Addition of Magnesium Sulfate to Local Anesthetics for Peribulbar Block: a Meta-Analysis for Randomized Trials

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