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Related Experiment Videos

Techniques of facial nerve block

F Schimek1, M Fahle

  • 1Eberhard-Karls-University, Tübingen, Germany.

The British Journal of Ophthalmology
|February 1, 1995
PubMed
Summary

The lid block is the safest and most effective facial nerve block for cataract surgery, providing complete eyelid akinesia. Modified O'Brien blocks also achieve akinesia but carry a higher risk of nerve injury.

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Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Neurosurgery

Background:

  • Facial nerve blocks are crucial for cataract surgery to prevent orbicularis oculi muscle activity.
  • Different techniques exist, including modified O'Brien, Atkinson, van Lint, and lid blocks, with varying reported efficacies.

Purpose of the Study:

  • To compare the efficacy of four facial nerve block techniques for cataract surgery.
  • To determine the safest and most effective method for achieving orbicularis oculi muscle akinesia.

Main Methods:

  • Quantitative EMG analysis of orbicularis oculi muscle activity before and after block.
  • Measurement of lid closure force and subjective assessment of lid motility.
  • Radiographic evaluation of injectate distribution for modified O'Brien and lid blocks.

Main Results:

  • Modified O'Brien and lid blocks significantly reduced EMG activity (p < 0.003) and lid closure force (p < 0.0001).
  • Atkinson and van Lint blocks showed no significant effect on muscle activity or lid function.
  • Radiography confirmed modified O'Brien block affects the facial nerve trunk and divisions, while lid block targets terminal branches.

Conclusions:

  • Both modified O'Brien and lid blocks achieve complete eyelid akinesia.
  • The lid block is recommended as the most effective and safest technique due to lower risk of neural injury compared to the modified O'Brien block.

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