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Retrobulbar anesthesia and orbicularis akinesia
Ophthalmic Surgery
|April 1, 1986
Summary
Retrobulbar injections effectively achieve orbicularis akinesia for intraocular surgery in 88% of patients. This technique reduces the need for additional facial nerve blocks, minimizing complications and improving patient outcomes.
Area of Science:
- Ophthalmology
- Anesthesia
Background:
- Simple retrobulbar injection can lead to orbicularis akinesia.
- The effectiveness of this phenomenon for surgical preparation needs prospective evaluation.
Purpose of the Study:
- To prospectively evaluate the effectiveness of a standard retrobulbar injection for achieving orbicularis akinesia.
- To determine the success rate of retrobulbar injection alone in providing adequate akinesia for intraocular surgery.
Main Methods:
- A prospective study of 50 patients undergoing intraocular surgery.
- Standard retrobulbar injection using 3 cc of bupivacaine and lidocaine mixture with epinephrine and hyaluronidase.
- Injection into the muscle cone via inferolateral lid entry with a 35-mm needle.
Main Results:
- Successful orbicularis akinesia was achieved in 44 out of 50 patients (88% success rate).
- Adequate akinesia allowed proceeding with intraocular surgery after a single retrobulbar injection in the majority of cases.
- Failure was defined as the need for a facial nerve block or lid movement during surgery.
Conclusions:
- Standard retrobulbar injection is a highly effective method for achieving orbicularis akinesia.
- This technique offers benefits such as reduced drug volume, decreased risk of nerve damage, less pain, ecchymosis, and edema.