Retrobular anaesthesia A clinical evaluation of four different anaesthetic mixtures

Johansen, Johnny; Kjeldgård, Michael; Corydon, Leif

doi:10.1111/j.1755-3768.1993.tb08601.x

Cited by 9 publications

(3 citation statements)

References 10 publications

(9 reference statements)

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“…With the group I solution and a volume of only 5 ml we reached a success rate as high as 77.8%. Johansen et al (1993) found a highest success rate of 73.5% in a retrobulbar study testing four different solutions. Comparing these two studies, the PBA is quite as effective as the RBA.…”

Section: Discussionmentioning

confidence: 95%

Peribulbar anaesthesia

Bjømstrøm

Hansen

Otland

et al. 1994

Acta Ophthalmologica

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Fifty-four consecutive cases of single injection peribulbar anaesthesia performed by the same ophthalmologist were evaluated concerning clinical effect on motility/akinesia and pain. The patients were randomly selected to one of two different mixtures of anaesthetics, one containing lidocaine, bupivacaine, adrenaline and hyaluronidase. The other lidocaine and bupivacaine. The mixture with adrenalin and hyaluronidase was significantly more effective than the other (success rates of 77.8% and 25.9%, p < 0.005).

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Section: Discussionmentioning

confidence: 95%

Peribulbar anaesthesia

Bjømstrøm

Hansen

Otland

et al. 1994

Acta Ophthalmologica

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“…Hyaluronidase is commonly used during needle block, perhaps the only regional block where it has been shown to be beneficial (Johansen et al. 1993; Bjørnstrøm et al.…”

Section: Twenty‐first Century Needle Blocksmentioning

confidence: 99%

“…Epinephrine is usually added to prolong the block and to improve its quality (Johansen et al. 1993; Bjørnstrøm et al.…”

Section: Twenty‐first Century Needle Blocksmentioning

confidence: 99%

Needle-based blocks for the 21st century ophthalmology

Kumar

2010

Acta Ophthalmologica

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Acta Ophthalmol. 2011: 89: 5–9 Abstract. Purpose: This paper reviews history of the needle orbital blocks used in the earlier centuries and how they have evolved towards safer anaesthesia in the modern clinical practice. Methods: Material is derived from literature searches from major ophthalmic and anaesthetic journals on the use of orbital needle blocks over earlier centuries. Results: Needle‐based anaesthetic techniques were described shortly after the invention of reliable medical needles. Atkinson popularized the classical retrobulbar block in a series of papers published in the early 20th century. This technique,which utilises a relatively long needle inserted towards the apex of the muscle cone behind the globe, has been criticized by some as unsuitable for modern 21st century ophthalmic surgery because of the extremely rare potential for serious complications. Satisfactory anaesthesia and akinesia can be obtained with short sharp or dull needles with slightly higher volumes of local anaesthetic agent placed in the farthest inferotemporal quadrant. Conclusion: Aside from relative safety, modern needle blocks offer the advantage of lid akinesia without a need for a second injection for the seventh nerve that is often performed con‐comitantly with retrobulbar block.

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Use of hyaluronidase as an adjunct to local anaesthetic eye blocks to reduce intraoperative pain in adults

Rüschen

Aravinth

Bunce

et al. 2018

Cochrane Database of Systematic Reviews

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Use of hyaluronidase as an adjunct to local anaesthetic eye blocks to reduce intraoperative pain in adults Patients or population: adults (aged ≥ 18 years) undergoing ophthalm ic surgery under local anaesthetic eye blocks. Setting: hospitals in the UK (4), Germ any (1), Brazil (1) and Iran (1). Intervention: local anaesthetic eye blocks containing hyaluronidase. Comparison: local anaesthetic eye blocks containing no hyaluronidase. * The risk in the intervention group (and its 95% conf idence interval) is based on the assum ed risk in the com parison group and the relative effect of the intervention (and its 95% CI). CI: conf idence interval; n.s: not statistically signif icant; RCT: random ized controlled trial; RR: risk ratio; SM D: standardized m ean dif f erence. GRADE Working Group grades of evidence High quality: we are very conf ident that the true ef f ect lies close to that of the estim ate of the ef f ect. M oderate quality: we are m oderately conf ident in the ef f ect estim ate: the true ef f ect is likely to be close to the estim ate of the ef f ect, but there is a possibility that it is substantially dif f erent. Low quality: our conf idence in the ef f ect estim ate is lim ited: the true ef f ect m ay be substantially dif f erent f rom the estim ate of the ef f ect. Very low quality: we have very little conf idence in the ef f ect estim ate: the true ef f ect is likely to be substantially dif f erent f rom the estim ate of ef f ect 1 Downgraded one level due to m arked heterogeneity with a calculated I 2 > 50%. 2 Downgraded one level f or im precision due to wide 95% conf idence intervals, ref lecting uncertainty in the direction of ef f ect estim ate. 3 Downgraded one level f or im precision and inconsistency in m easurem ent, lack of data and sm all sam ple size.

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Retrobular anaesthesia A clinical evaluation of four different anaesthetic mixtures

Cited by 9 publications

References 10 publications

Peribulbar anaesthesia

Peribulbar anaesthesia

Needle-based blocks for the 21st century ophthalmology

Use of hyaluronidase as an adjunct to local anaesthetic eye blocks to reduce intraoperative pain in adults

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