Retrobulbar vs peribulbar regional anesthesia techniques using bupivacaine in dogs

Shilo‐Benjamini, Yael; Pascoe, Peter J; Maggs, David J.; Hollingsworth, Steven R.; Strom, Ann R.; Good, Kathryn L.; Thomasy, Sara M; Kass, Philip H.; Wisner, Erik R.

doi:10.1111/vop.12579

Cited by 20 publications

(25 citation statements)

References 26 publications

(56 reference statements)

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“…A variety of orbito‐ocular block techniques and their efficacy have been reported in veterinary medicine including retrobulbar, peribulbar, splash block, and local anesthetic‐infused hemostatic sponges . Retrobulbar blocks are technically fairly simple to perform, although they are not without risk .…”

Section: Introductionmentioning

confidence: 99%

A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation

Zibura

Posner

Ru³

et al. 2019

Veterinary Ophthalmology

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Purpose Investigate nociception differences in dogs undergoing enucleation administered bupivacaine either via preoperative retrobulbar block (pRB) or intraoperative splash block (iSB). Methods Prospective, randomized, double‐masked, clinical comparison study. Dogs undergoing unilateral enucleation were randomized to two groups: one received bupivacaine pRB and saline iSB of the same volume, and the other received saline pRB and bupivacaine iSB. The following intraoperative parameters were recorded: heart rate (HR), respiratory rate (RR), end‐tidal CO2 (EtCO2); systolic, mean, and diastolic arterial blood pressure (SAP, MAP, and DAP respectively); inspired end‐tidal isoflurane concentration (EtISOIns), and expired end‐tidal isoflurane concentration (EtISOExp). Pain scores were recorded pre‐ and postoperatively. Analgesic rescue was documented. Surgical hemorrhage and postoperative bruising and swelling were graded subjectively by the surgeon (HDW) and study coordinator (AEZ). Results A significant (P = .0399) increase from baseline in overall mean heart rate was recorded in iSB bupivacaine patients (n = 11) compared with pRB bupivacaine patients (n = 11), with no significant differences in other intraoperative physiologic parameters, or pain scores. More analgesic rescue events occurred in iSB bupivacaine patients compared to pRB bupivacaine patients. A near‐significant increase in intraoperative bleeding (P = .0519), and a significant increase in bruising (P = .0382) and swelling (P = .0223) was noted in the iSB bupivacaine group. Conclusions Preoperative retrobulbar block bupivacaine is more effective than an iSB bupivacaine at controlling both intraoperative and postoperative nociception in dogs undergoing enucleation. Additionally, iSB causes more postoperative bruising and swelling and may be associated with increased intraoperative hemorrhage.

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Section: Introductionmentioning

confidence: 99%

A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation

Zibura

Posner

Ru³

et al. 2019

Veterinary Ophthalmology

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“…Reported volumes for a PBB are two to four times the volume for an RBB. 11,12 This volume then dissipates throughout the orbit, including passively into the muscle cone and eyelids, providing complete anaesthesia of the eye. In contrast, an RBB involves deposition of local anaesthetic intraconally, which carries risks, including damage to intraconal structures, retrobulbar haemorrhage, extraocular muscle damage, globe perforation and meningitis.…”

Section: Peribulbar Blockmentioning

confidence: 99%

Peribulbar block in a rabbit presenting for enucleation

Ryan¹,

Dutton

Gurney³

2022

Vet Record Case Reports

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This paper discusses the use of a peribulbar local block with bupivacaine in a rabbit presenting for enucleation and represents an alternative locoregional technique to a retrobulbar block, which is challenging to perform in rabbits due to the presence of a venous sinus behind the globe. A peribulbar block is comparatively easy to perform, and it provided excellent perioperative and postoperative analgesia in the case reported. Clinicians should consider a peribulbar block as part of a multimodal anaesthetic plan where indicated.

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“…Como o bulbo ocular e suas glândulas anexas apresentam uma densa inervação sensorial e motora, a anestesia pode ser indicada tanto para auxiliar no diagnóstico de uma patologia, quanto para a realização de procedimentos cirúrgicos (Shilo-Benjamini, 2019). Os bloqueios anestésicos locais são indicados para procedimentos mais invasivos tais como a enucleação, flaps para correções de úlceras de córnea, ceratotomia, biópsias incisionais da conjuntiva, colocação de retalhos da terceira pálpebra, remoção de corpos estranhos da córnea e cirurgias na pálpebra ( Honsho et al, 2014;Shilo-Benjamini et al, 2019).…”

Section: Considerações Anatômicasunclassified

Principais bloqueios anestésicos para cirurgias oculares em cães e gatos

Pinto

Ribeiro

Silva

et al. 2021

RSD

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O objetivo do trabalho é realizar uma revisão de literatura dos principais bloqueios anestésicos utilizados em cirurgias oculares de cães e gatos, mostrando quando devem ser indicados, as formas de aplicação, as principais vantagens e as complicações que mais ocorrem neste tipo de anestesia. Realizou-se uma revisão narrativa, utilizando artigos científicos, monografias, teses e dissertações publicadas e disponíveis nas bases de dados online: Periódico Capes (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), SciELO (Scientific Electronic Library Online) e Google Acadêmico, além de livros específicos do tema. Os principais bloqueios anestésicos utilizados para cirurgia ocular são o retrobulbar, o peribulbar e os bloqueios palpebrais, além da anestesia da superfície ocular. O uso de bloqueios oftálmicos, quando realizados de maneira adequada, representa um complemento eficaz à anestesia geral, uma vez que diminuem os efeitos sistêmicos de fármacos, diminuem a necessidade de anestésicos inalatórios e/ou intravenosos, além de proporcionarem analgesia pós-operatória. Em virtude da maior proximidade e cuidado dos animais por seus tutores, nos últimos anos têm aumentado o número de procedimentos oftálmicos na clínica de cães e gatos. Assim, é importante que o anestesista tenha conhecimento sobre as particularidades da anestesia nesses pacientes, bem como sobre os principais bloqueios usados na região craniana e qual a técnica e o anestésico local mais adequado para cada tipo de procedimento.

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Retrobulbar vs peribulbar regional anesthesia techniques using bupivacaine in dogs

Abstract: Peribulbar injection produced notable anesthesia more reliably than did retrobulbar injection. Both techniques may produce adverse effects, although the uveitis/ulcer could have resulted from the contrast agent used.

Cited by 20 publications

References 26 publications

A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation

A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation

Peribulbar block in a rabbit presenting for enucleation

Principais bloqueios anestésicos para cirurgias oculares em cães e gatos

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