Ahmet ŞEN, Tuğcehan SEZER AKMAN

Regional Anesthesia in Ophthalmic Surgery

There are many anesthesia techniques for use in ophthalmic surgery. In selecting the technique to be applied, individual characteristics and anesthetic and surgical targets should all be considered for each patient. Regional techniques are preferred over general anesthesia due to their low complication rate and advantages. However, although it is relatively rare, regional techniques can also have life-threatening complications. Ophthalmologists and anesthesiologists should be prepared to handle the rare yet severe complications that the orbital regional anesthesia technique may cause. This study aims to uncover the regional anesthesia techniques used in ophthalmic surgeries and the complications that may arise

Keywords:

anesthesia, regional anesthesia local anesthesia, ophthalmic surgery,

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Akkaya S, Wang S. Local anesthesia techniques for ocular surgery. Transl Perioper Pain Med. 2018;5(1):14–8.
2. Wakeman B, Machuk R, Somani R. Mah D, MacDonald I. Recognizing and mitigating risk of ophthalmic regional anesthesia. In: Finucane B., Tsui B. (eds) Complications of Regional Anesthesia. Springer; 2017. p. 23.
3. Nouvellon E, Cuvillon P, Ripart J. Regional anesthesia and eye surgery. Anesthesiology. 2010;113(5):1236–42.
4. Bor C, Çertuğ A. Anesthesia in ophtalmic surgery. Ege J Med. 2015;54:46–53.
5. Nysora. Local and Regional Anesthesia for Ophthalmic Surgery; 2023 [Accessed: 16.07.2023]. https://www.nysora. com/regional-anesthesia-for-specific-surgical-procedures/headand-neck/ophthalmic/local-regional-anesthesia-ophthalmicsurgery/
6. Alhassan MB, Kyari F, Ejere HO. Peribulbar versus retrobulbar anaesthesia for cataract surgery. Cochrane Database Syst Rev. 2015(7):CD004083.
7. Anker R, Kaur N. Regional anaesthesia for ophthalmic surgery. BJA Educ. 2017;17(7): 221–7.
8. Scribd. Anesthesia for cataract surgery; 2023 [Accessed: 16.07.2023]. https://www.scribd.com/document/361727167/ Anesthesia-for-Cataract-Surgery-pdf
9. Oğurel T. Two cases possible brain stem anesthesia after retrobulbar block. KÜ Tıp Fak Derg. 2013:31–2.
10. Yaşar T, Çağlar Ç. Local injection anesthesias in ophthalmic surgery. T Oft Gaz. 2009;39(6):496–505.
11. Kazancıoğlu L, Batçık Ç, Kazdal H, Şen A, Gediz B, Erdivanlı B. Peribulbar block complication: Brainstem anesthesia. Turk J Anaesthesiol Reanim. 2017;45:231-3.
12. Fahmi A, Bowman R. Administering an eye anaesthetic: principles, techniques and complications. Community Eye Health. 2008;21(65);14–7.
Vagge A, Simonetti F, Marenco M, Burtolo C, Musolino M, Traverso CE. Peribulbar anesthesia for strabismus surgery in adult patients. Eur J Ophthalmol. 2021;31(6):3367–71.
14. Basu C, Başak S. Brainstem anesthesia: A rare complication after peribulbar anesthesia. Indian J Case Rep. 2021;7(2):47–9.
15. Ripart J, Nouvellon E, Chaumeron A. Regional anesthesia for eye surgery. Reg Anesth Pain Med. 2005;30(1):72–82.
16. Carneiro HM, Teixeira KI, de Ávila MP, Limongi RM, Magacho L. Comparison of needle path, anesthetic dispersion, and quality of anesthesia in retrobulbar and peribulbar blocks. Reg Anesth Pain Med. 2016;41(1):37–42.
17. Fang ZT, Liew EC, Keyes MA. Anesthesia for ophthalmic surgery. Miller’s Anesthesia. 2020, 9th ed. Elsevier Inc.
18. Sirisha CKV, Satish K, Chandra TJ. A comparative study of the efficacy and safety of peribulbar anaesthesia with that of retrobulbar anaesthesis in patients undergoing cataract surgeries. International Journal of Pharmaceutical and Clinical Research. 2022;14(10);513–17.
19. Nithisha TM, Neethu N. To compare the effectiveness of sub-tenon’s anesthesia with peribulbar anesthesia in patients undergoing manual small-incision cataract surgery. Int J Sci Study. 2019;7(4):66–9.
20. Tighe R, Burgess PI, Msukwa G. Teaching corner: Regional anaesthesia for ophthalmic surgery. Malawi Med J. 2012;24(4):89–94.
Yazici B, Poroy C, Yayla U. Combined retro-peribulbar and subconjunctival anesthesia for evisceration surgery. Int Ophthalmol. 2020;40(1):1–5.
22. Upadhyay P, Ichhpujani P, Solanki A. Recent trends in anesthetic agents and techniques for ophthalmic anesthesia. J Anaesthesiol Clin Pharmacol. 2022;1–6.
23. McRae L, Presland A. A review of current ophthalmic anaesthetic practice. Br Med Bull. 2020;135(1):62–72.
24. Wang L, Li J, Li G, Xu X, Tao H, Chen W. Combined topicalintracameral anesthesia in manual small-incision cataract surgery: A prospective, randomized, double-masked, placebocontrolled trial. Asia Pac J Ophthalmol (Phila). 2013;2(1):9– 14.
25. Nebbioso M, Livani ML, Santamaria V, Librando A, Sepe M. Intracameral lidocaine as supplement to classic topical anesthesia for relieving ocular pain in cataract surgery. Int J Ophthalmol. 2018;11(12):1932–35.
26. Gayer S, Palte HD. Ultrasound-guided ophthalmic regional anesthesia. Curr Opin Anaesthesiol. 2016;29(6):655–61.
27. Palte HD. Ophthalmic regional blocks: management, challenges, and solutions. Local Reg Anesth. 2015;8:57–70.
28. Kumar CM. Orbital regional anesthesia: complications and their prevention. Indian J Ophthalmol. 2006;54:77–84.