Apnea and seizures following retrobulbar local anesthetic injection

Surgery on the eye is performed using topical anesthesia, retrobulbar anesthesia, peribulbar anesthesia, and general anesthesia. Retrobulbar anesthesia is associated with a number of complications that include apnea (respiratory arrest), seizures, or both. Although these complications are transient and self-limiting, they can be life-threatening if not recognized and treated early. We report two patients who developed apnea, one of whom had cardiorespiratory arrest; and two other patients who presented with seizures. We provided ventilation with 100% oxygen, treated the hypertension with nicardipine, and the tachycardia with esmolol. The patients did not have any residual complications.