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Visual evoked potentials after retrobulbar or periocular anaesthesia
A Ropo1, P Ruusuvaara, K Setälä
1Department of Ophthalmology, Helsinki University Central Hospital, Finland.
The British Journal of Ophthalmology
|September 1, 1992
Summary
Local anesthetic etidocaine can affect optic nerve function during eye surgery. Retrobulbar injections showed more significant visual evoked potential (VEP) changes than periocular injections.
Area of Science:
- Ophthalmology
- Neuroscience
- Anesthesiology
Background:
- Regional ophthalmic anesthesia is crucial for cataract surgery.
- Local anesthetics can potentially impact optic nerve function.
- Visual evoked potential (VEP) is a key measure of optic nerve function.
Purpose of the Study:
- To evaluate the effect of etidocaine, a local anesthetic, on optic nerve function.
- To compare the impact of retrobulbar versus periocular anesthesia on VEP.
- To assess changes in VEP following regional ophthalmic anesthesia.
Main Methods:
- VEP recordings were taken before and after anesthetic injection in 19 patients undergoing cataract surgery.
- Patients received either retrobulbar (seven) or periocular (12) anesthesia.
- Both the operated and fellow eyes were examined.
Main Results:
- Two patients in the retrobulbar group had non-recordable VEPs; one had nearly undetectable waves.
- Two retrobulbarly anesthetized eyes showed unidentifiable later peaks, and two had decreased amplitudes.
- Most periocular injections (nine of 12) had no significant VEP effect, while three showed mild changes.
Conclusions:
- Retrobulbar anesthesia with etidocaine appears to have a more pronounced effect on optic nerve function (VEP) than periocular anesthesia.
- Differences in VEP changes may be attributed to varying anesthetic concentrations around the optic nerve.
- Further research is needed to fully understand the neurotoxic potential of local anesthetics in ophthalmic procedures.