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Ophthalmic regional blocks: management, challenges, and solutions.

Howard D Palte¹

¹Department of Anesthesiology, Perioperative Medicine and Pain Management, Miller School of Medicine, University of Miami, Miami, FL, USA.

Local and Regional Anesthesia

|August 29, 2015

Summary

Ophthalmic anesthesia has shifted from general to regional and topical anesthesia for eye surgeries. Anesthesiologists need enhanced training in eye blocks to improve efficiency and manage patient needs.

Keywords:

anticoagulation hyaluronidase ocular trauma ophthalmic anesthesia ultrasound venous air embolism

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Area of Science:

Anesthesiology
Ophthalmology

Background:

Ophthalmic anesthesia has transformed, moving from general anesthesia in hospitals to regional and topical anesthesia in eye care centers.
The growing elderly population necessitates efficient surgical practices, driving demand for improved anesthetic techniques.

Purpose of the Study:

To review current trends and topical issues in ophthalmic anesthesia.
To emphasize needle-based and cannula blocks, new antithrombotic agents, and ultrasound guidance.

Main Methods:

Review of current literature on ophthalmic anesthesia techniques.
Discussion of regional block advancements, including sub-Tenon's and peribulbar approaches.
Exploration of adjuncts like hyaluronidase and the role of ultrasound guidance.

Main Results:

Sub-Tenon's block is gaining popularity, while retrobulbar blocks are less common.
Phacoemulsification enables topical anesthesia for cataract surgery.
Ultrasound guidance enhances safety by visualizing needle placement and anatomy, reducing risks like globe perforation.

Conclusions:

Anesthesiologists require updated training in ophthalmic regional blocks to meet evolving surgical demands and economic pressures.
Ultrasound-guided blocks offer improved safety and efficiency in ophthalmic anesthesia.
The shift towards regional and topical anesthesia reflects advancements in surgical techniques and anesthetic practices.