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Topography of peribulbar anesthesia
1Department of Anesthesia, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Regional Anesthesia
|July 1, 1995
Summary
Peribulbar anesthesia involves specific puncture points. Computed tomography confirmed that superior internal eyelid angle punctures are safe, while median or external superior angle punctures risk eye globe perforation.
Area of Science:
- Ophthalmology
- Anesthesiology
- Medical Imaging
Background:
- Peribulbar anesthesia is preferred over retrobulbar anesthesia due to fewer complications.
- Ocular perforation remains a potential risk even with peribulbar anesthesia.
Purpose of the Study:
- To utilize computed tomography (CT) to assess the anatomical safety of recommended peribulbar anesthesia puncture sites.
- To identify peribulbar anesthesia injection points that minimize the risk of ocular perforation.
Main Methods:
- CT scans were performed on three human cadavers.
- Injections were administered at three distinct upper eyelid puncture points: superior internal (A), median (B), and superior external (C) orbital angles.
- Contrast diffusion was evaluated at 3, 4, 5, and 10 minutes post-injection.
Main Results:
- The superior internal orbital angle puncture site (A) was found to be anatomically safe.
- Punctures at the superior median (B) and superior external (C) orbital angles carried a risk of eye globe perforation.
- Lower eyelid puncture sites demonstrated a safe distance from the optic nerve and globe.
- Satisfactory contrast diffusion was observed in positions A and B, with limited diffusion in position C.
Conclusions:
- Superior median and external angle eyelid punctures for peribulbar anesthesia pose a risk of ocular perforation.
- The superior internal angle puncture is the anatomically safest site for upper eyelid peribulbar anesthesia.
- Lower eyelid puncture sites are considered safe.