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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Chemistry and Structure-Activity Relationship01:30

Local Anesthetics: Chemistry and Structure-Activity Relationship

Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

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Corneal and Limbal Alkali Injury Induction Using a Punch-Trephine Technique in a Mouse Model
07:39

Corneal and Limbal Alkali Injury Induction Using a Punch-Trephine Technique in a Mouse Model

Published on: August 4, 2023

Strabismus complications from local anesthetics.

David L Guyton1

  • 1The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD 21287-9028, USA. dguyton@jhmi.edu

Seminars in Ophthalmology
|December 17, 2008
PubMed
Summary
This summary is machine-generated.

Strabismus after eye surgery anesthesia can cause double vision due to muscle damage. Surgical correction, often involving adjustable sutures, can restore alignment and prevent future complications.

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Surgical Correction for Pediatric Epiblepharon and Trichiasis
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Corneal and Limbal Alkali Injury Induction Using a Punch-Trephine Technique in a Mouse Model
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Surgical Correction for Pediatric Epiblepharon and Trichiasis
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Published on: July 8, 2025

Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Surgical Complications

Background:

  • Strabismus, or eye misalignment, can occur postoperatively following retrobulbar or peribulbar anesthesia.
  • This complication is linked to local anesthetic myotoxicity affecting extraocular muscles.

Purpose of the Study:

  • To investigate the etiology and management of strabismus developing after local anesthesia for eye surgery.
  • To highlight the potential for anesthetic agents to cause extraocular muscle damage.

Main Methods:

  • Review of cases experiencing strabismus post-anesthesia.
  • Analysis of anesthetic techniques and surgical outcomes.
  • Focus on the inferior rectus muscle as the commonly affected site.

Main Results:

  • Anesthetic myotoxicity can lead to initial muscle paresis and subsequent fibrosis or hypertrophy.
  • This progression can cause diplopia, with directionality changing over time.
  • The inferior rectus muscle is most frequently impacted.

Conclusions:

  • Large recession surgery using adjustable sutures is an effective treatment for anesthetic-induced strabismus.
  • Employing topical or sub-Tenon's anesthesia can prevent this specific complication.