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Are ocular injection anesthetic blocks obsolete? Indications and guidelines
Nikolaos A Mavrakanas1, Christina Stathopoulos, James S Schutz
1Ophthalmology Service, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
Current Opinion in Ophthalmology
|November 20, 2010
Summary
Sub-Tenon
Area of Science:
- Ophthalmology
- Anesthesiology
Background:
- Topical anesthesia is common for ocular surgery.
- Anesthetic ocular blocks remain crucial for procedures requiring profound anesthesia and akinesia.
- Injection blocks (retrobulbar, peribulbar) are still widely used despite the safety of sub-Tenon's blocks.
Purpose of the Study:
- To review current international preferences for ocular anesthesia injection blocks.
- To explore reasons for the limited adoption of sub-Tenon's blocks.
- To provide guidelines for safer injection techniques.
Main Methods:
- Literature survey of publications over the last 5 years.
- Analysis of current international preferences for ocular anesthesia.
- Review of safety profiles and indications for different block types.
Main Results:
- Sub-Tenon's block is safer but not universally preferred.
- Specific indications for injection blocks are identified.
- Guidelines for reducing complications with retrobulbar anesthesia are presented.
Conclusions:
- Sub-Tenon's block is recommended over injection blocks except for specific indications.
- Retrobulbar anesthesia, with specific techniques, may be safer than peribulbar anesthesia when injections are necessary.
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