Teaching corner: Regional anaesthesia for ophthalmic surgery

Area of Science:

• Ophthalmology
• Anesthesiology

Background:

• Regional anesthesia is essential for ophthalmic surgery.
• Sharp-needle blocks, while effective, pose risks of serious complications.
• Sub-Tenon's block with a blunt cannula is a safer alternative but not without risks.

Purpose of the Study:

• To review the anatomy relevant to ophthalmic regional anesthesia.
• To discuss local anesthetic drugs and common techniques.
• To provide a practical guide for the safe performance of these blocks.

Main Methods:

• Review of anatomical structures pertinent to ophthalmic anesthesia.
• Analysis of local anesthetic properties and selection.
• Description of commonly employed regional anesthesia techniques for ophthalmic surgery.

Main Results:

• Sharp-needle blocks have a low incidence of severe sight- and life-threatening complications.
• Sub-Tenon's block using a blunt cannula offers akinesia and is generally safer.
• Serious complications, though rare, have been reported with Sub-Tenon's block.

Conclusions:

• Safe performance of regional anesthesia for ophthalmic surgery requires understanding anatomy and techniques.
• Blunt cannula Sub-Tenon's block is a preferred safer alternative to sharp-needle blocks.
• Continuous vigilance and proper technique are necessary to minimize risks associated with ophthalmic blocks.