Using the oculocephalic reflex to assess effective retrobulbar anesthesia

In order to confirm effective retrobulbar anesthesia, we attempted to stimulate the oculocephalic reflex (the doll's head phenomenon) in 40 consecutive patients undergoing elective cataract extraction with intravenous sedation. Thirty-nine of these 40 patients had a positive response, exhibiting the reflex in the nonanesthetized eye but not in the anesthetized eye. Using this test in sedated patients obviates interrupting surgery to administer additional block under less than optimal, uncontrolled conditions.