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Simulated peribulbar injection of anesthetic
K Zahl1, J M Nassif, M A Meltzer
1Department of Anesthesiology, Mount Sinai School of Medicine, New York.
Annals of Ophthalmology
|March 1, 1991
Summary
Peribulbar injections may cause local anesthetic to spread intracranially, potentially leading to serious complications like brainstem anesthesia. Vigilance is crucial during peribulbar and retrobulbar injections to prevent adverse events.
Area of Science:
- Ophthalmology
- Anesthesiology
- Anatomy
Background:
- Peribulbar and retrobulbar injections are common procedures for ocular anesthesia.
- Potential complications, including intracranial spread of local anesthetics, are a concern.
Purpose of the Study:
- To investigate the possibility of intracranial spreading of local anesthetic following peribulbar injection.
Main Methods:
- Simulated peribulbar anesthetic injections using radiopaque dye were performed on two cadaver heads.
- Standard and modified peribulbar techniques with a 25-gauge needle were utilized, injecting 8 mL of dye into four orbits.
- Computed tomography (CT) was used to visualize dye spread.
Main Results:
- Radiopaque dye spread both intraconally and intracranially in the simulated injections.
- In one instance, dye was observed tracking along the optic nerve sheath.
Conclusions:
- Intracranial spreading of local anesthetics after peribulbar injection is a potential risk.
- This spread may be associated with adverse sequelae, such as brainstem anesthesia.
- Caution and vigilance are recommended during peribulbar and retrobulbar anesthetic injections to mitigate risks of cardiopulmonary compromise.