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A Case of Brainstem Anesthesia after Retrobulbar Block for Globe Rupture Repair
Tavish Nanda1,2, Lisa Ross3, Gregory Kerr3
1Department of Ophthalmology, NYC Health+Hospitals/Harlem, New York, NY, USA.
Case Reports in Anesthesiology
|December 23, 2021
Summary
A rare case of brainstem anesthesia following a retrobulbar block highlights the importance of careful anesthetic administration. Judicious use of anesthetic volume and needle length can reduce the risk of this serious complication.
Area of Science:
- Anesthesiology
- Ophthalmology
Background:
- Retrobulbar blocks are commonly used for ophthalmic procedures.
- Complications, though rare, can be severe, including central nervous system (CNS) effects.
Observation:
- A 72-year-old female developed apnea and increased end-tidal CO2 (ETCO2) after a retrobulbar block.
- The patient received 5 mL of 0.5% bupivacaine for postoperative pain management.
Findings:
- The patient's symptoms were consistent with brainstem anesthesia, a rare but life-threatening complication.
- Early recognition and management are crucial to prevent adverse outcomes like respiratory arrest.
Implications:
- Judicious use of anesthetic volume and shorter needles can minimize the risk of CNS spread.
- Monitoring pupillary changes in the contralateral eye can aid in early detection of CNS involvement.
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