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Convulsions during cataract surgery under peribulbar anesthesia: a case report
Mustapha Bensghir1, Najlae Badou, Abdelhafid Houba
1Department of Anesthesiology Military Hospital Mohammed V Rabat, University of Mohammed V Souissi, Rabat, Morocco. mustaphabens_15rea@hotmail.com.
Journal of Medical Case Reports
|June 25, 2014
Summary
Peribulbar anesthesia for cataract surgery can lead to serious complications like seizures and hypertension. Careful technique and adherence to safety standards are crucial for preventing adverse events in ophthalmic anesthesia.
Area of Science:
- Ophthalmology
- Anesthesiology
- Neurosurgery
Background:
- Locoregional anesthesia, particularly peribulbar anesthesia, is widely used for cataract surgery due to its effectiveness and safety.
- Despite its success, peribulbar anesthesia carries inherent risks that necessitate careful consideration.
Observation:
- A case of a 70-year-old man undergoing cataract surgery presented with severe hypertension (209/115mmHg) five minutes after peribulbar anesthesia.
- Generalized tonic-clonic seizures occurred one minute after blood pressure management, requiring tracheal intubation.
Findings:
- The patient received peribulbar anesthesia using a mixture of lidocaine 2% and bupivacaine 0.5% via two injections.
- Post-anesthesia complications included hypertensive crisis and generalized seizures, necessitating immediate medical intervention and airway management.
Implications:
- This case highlights the potential for serious neurological and cardiovascular complications associated with peribulbar anesthesia.
- Emphasizes the critical importance of practitioner expertise, meticulous technique, and strict adherence to safety protocols in ophthalmic anesthesia to mitigate risks.
