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Update on regional anaesthesia in intraocular surgery
S Wenger1, C Luyet2, J G Garweg3
1Dept. Anaesthesiology, Inselspital, Bern, Switzerland (Med. Director: Prof. Dr. med. F. Stüber).
Klinische Monatsblatter Fur Augenheilkunde
|April 23, 2015
Summary
Retrobulbar anesthesia offers a high success rate for intraocular surgeries, especially in high-risk patients. Careful technique ensures effective pain control and minimizes rare but serious complications.
Area of Science:
- Ophthalmology
- Anesthesiology
Background:
- Retrobulbar anesthesia is a safe and effective local anesthesia technique for intraocular surgeries.
- It is particularly beneficial for polymorbid and hemodynamically compromised patients.
- While rare, potential complications can be severe.
Purpose of the Study:
- To review current techniques and complications of retrobulbar anesthesia.
- To provide guidance for managing patients on anticoagulant or antiplatelet therapy undergoing retrobulbar anesthesia.
- To compare different retrobulbar anesthesia approaches based on available literature.
Main Methods:
- Review of existing literature on retrobulbar anesthesia techniques and outcomes.
- Analysis of contraindications for regional anesthesia in ophthalmic surgery.
- Discussion of patient management strategies, especially concerning anticoagulation.
Main Results:
- Retrobulbar anesthesia achieves nearly 100% success in controlling intraoperative discomfort.
- High success rates are associated with intraconal injection (94%) and fluid distribution (97%).
Conclusions:
- Retrobulbar anesthesia is a highly successful method for intraocular procedures.
- Management guidelines are proposed for patients on antithrombotic therapy due to lack of evidence-based studies.
- Further research is needed for evidence-based recommendations regarding anticoagulation and retrobulbar anesthesia.
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