Subarachnoid injection during retrobulbar block: a case report

Area of Science:

• Anesthesiology
• Neurology

Background:

• Retrobulbar block is a common anesthesia technique for ophthalmic procedures.
• Potential complications, though rare, require vigilance.

Observation:

• A patient developed central nervous system toxicity, respiratory arrest, and cardiac depression minutes after a retrobulbar block.
• Symptoms included restlessness, confusion, bradycardia, and hypotension.

Findings:

• The clinical presentation strongly suggested subarachnoid injection of local anesthetic, leading to brain stem anesthesia.
• Rapid intubation, ventilation, and supportive care resulted in full recovery within one hour.

Implications:

• Anesthesiologists must be prepared to recognize and manage subarachnoid injection, a serious complication of retrobulbar blocks.
• Vigilant monitoring and prompt intervention are critical for favorable outcomes.