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A modified retrobulbar block for eye surgery

D H Wong1, E Koehrer, H F Sutton

  • 1Department of Anaesthesia, Faculty of Medicine, University of British Columbia, Vancouver, Canada.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|June 1, 1993
PubMed
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A modified retrobulbar block (MRB) offers superior muscle akinesia for cataract surgery compared to traditional retrobulbar (RB) and peribulbar (PB) blocks. This safer, effective ocular anesthesia technique improves surgical conditions and patient acceptance.

Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Surgical Techniques

Background:

  • Ocular anesthesia is crucial for cataract surgery.
  • Traditional retrobulbar (RB) and peribulbar (PB) blocks are common methods.
  • Need for improved efficacy and safety in ocular blockade.

Purpose of the Study:

  • To compare the efficacy and safety of a modified retrobulbar block (MRB) with classical RB and PB.
  • To evaluate akinesia rates, supplemental block requirements, surgical conditions, and patient acceptance.

Main Methods:

  • Randomized, prospective, surgeon-blinded study.
  • 150 patients undergoing cataract surgery.
  • Comparison of MRB (single superomedial injection) versus RB and PB.

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Main Results:

  • MRB demonstrated significantly higher rates of total akinesia for orbicularis oculi and several extraocular muscles compared to RB and PB.
  • MRB required fewer supplemental blocks.
  • No serious complications were reported in any group; MRB provided excellent surgical conditions and high patient acceptance.

Conclusions:

  • Modified retrobulbar block (MRB) is a safe and effective alternative for ocular anesthesia in cataract surgery.
  • MRB offers superior muscle akinesia and improves surgical outcomes.
  • High patient acceptance and reduced need for supplemental blocks support MRB's utility.