ABSTRACT
Even as current trends move away from retrobulbar block and topical anesthesia gains greater widespread acceptance, ocular anesthesia is most commonly administered with a needle. Although rare, complications have been described, ranging from innocuous hemorrhage to life-threatening systemic situations.
Subject(s)
Anesthesia, Local/adverse effects , Eye Diseases/surgery , Postoperative Complications/etiology , Anesthesia, Local/methods , Blepharoptosis/etiology , Eye Injuries, Penetrating/etiology , Humans , Retrobulbar Hemorrhage/etiology , Risk FactorsSubject(s)
Anesthesia, Local/adverse effects , Anesthetics, Combined/administration & dosage , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Lidocaine/administration & dosage , Retrobulbar Hemorrhage/prevention & control , Connective Tissue , Diabetes Mellitus, Type 1/complications , Humans , Nausea/etiology , Pain/etiology , Retrobulbar Hemorrhage/etiology , Vitrectomy , Vitreous Hemorrhage/surgeryABSTRACT
We present a case of retrobulbar hemorrhage complicating sub-Tenon's anesthesia in a patient receiving oral anticoagulants. To our knowledge, this has been described only once in the literature.
Subject(s)
Anesthesia, Local/adverse effects , Anesthetics, Combined/administration & dosage , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Lidocaine/administration & dosage , Retrobulbar Hemorrhage/etiology , Connective Tissue , Diabetes Mellitus, Type 1/complications , Female , Humans , Middle Aged , Nausea/etiology , Pain/etiology , Vitrectomy , Vitreous Hemorrhage/surgerySubject(s)
Complementary Therapies/adverse effects , Injections/adverse effects , Myopia, Degenerative/therapy , Retinal Perforations/diagnosis , Retinal Perforations/etiology , Treatment Failure , Vision Disorders/etiology , Acute Disease , Humans , Male , Middle Aged , Myopia, Degenerative/complications , Retrobulbar Hemorrhage/diagnosis , Retrobulbar Hemorrhage/etiology , Russia , Treatment Outcome , Vision Disorders/diagnosisABSTRACT
We present a case of retrobulbar hemorrhage from uneventful, infranasal, sub-Tenon's anesthesia before cataract surgery. To our knowledge, this is the first report of such a complication.
Subject(s)
Anesthesia, Local/adverse effects , Anesthetics, Local/adverse effects , Connective Tissue , Phacoemulsification , Prilocaine/adverse effects , Retrobulbar Hemorrhage/etiology , Aged , Fascia , Female , Humans , Lens Implantation, IntraocularABSTRACT
We report a case of orbital varix rupture during cataract surgery with retrobulbar anesthesia. No remarkable changes were observed 10 minutes after retrobulbar anesthesia was administered, but a rise in intraocular and intraorbital pressure was noted about 10 minutes after phacoemulsification began. The eyelid could not be closed at the end of surgery because of severe proptosis. Follow-up by magnetic resonance imaging and color Doppler imaging revealed orbital hemorrhage and varix. Based on the time of its appearance, the hemorrhage was thought to be the result of venous congestion caused by anesthetic agent in the muscle cone. Although intermittent exophthalmos is a symptom of orbital varix, silent orbital varix should be considered when selecting the method of anesthesia for ocular surgery.
Subject(s)
Orbit/blood supply , Phacoemulsification , Retrobulbar Hemorrhage/etiology , Varicose Veins/complications , Aged , Anesthesia, Local , Humans , Intraocular Pressure , Magnetic Resonance Imaging , Male , Rupture, Spontaneous , Ultrasonography, Doppler, Color , Varicose Veins/diagnosisSubject(s)
Anesthesia, Local/instrumentation , Anesthetics, Local/adverse effects , Bupivacaine/adverse effects , Cataract Extraction , Corneal Transplantation , Hematoma/etiology , Hypertension/etiology , Injections/adverse effects , Intraoperative Complications/etiology , Mental Disorders/etiology , Needles , Orbit , Postoperative Complications/etiology , Retrobulbar Hemorrhage/etiology , Tachycardia/etiology , Adult , Aged , Aged, 80 and over , Anesthetics, Local/administration & dosage , Blood Vessels/injuries , Bupivacaine/administration & dosage , Equipment Design , Headache/etiology , Humans , Injections/instrumentation , Male , Mydriasis/etiologyABSTRACT
Potential side-effects caused by complementary medicines are often not anticipated. A case is reported of bilateral retro-bulbar haemorrhages with elevated intraocular pressure during strabismus surgery that occurred as a result of odourless garlic tablet ingestion prescribed by a naturopath. A near-catastrophic event was averted with rapid recognition and medical treatment. This is believed to be the first such report of haemorrhaging in ophthalmic surgery induced by garlic. It is concluded that unregulated naturopathic prescribing is potentially dangerous; doctors need to ask specifically about naturopathic potions.
Subject(s)
Exotropia/surgery , Garlic/adverse effects , Retrobulbar Hemorrhage/etiology , Complementary Therapies/adverse effects , Female , Humans , Intraocular Pressure , Middle Aged , Oculomotor Muscles/surgeryABSTRACT
PURPOSE: To report the occurrence of delayed orbital hemorrhage after cataract surgery with retrobulbar anesthesia in a patient with previously unknown acquired factor VIII antibodies. METHODS: Interventional case report. A 79-year-old woman underwent uneventful cataract surgery with retrobulbar anesthesia and subsequently incurred a severe orbital hemorrhage 12 hours postoperatively. RESULTS: Despite aggressive surgical and medical intervention, the patient lost all vision in the involved eye. CONCLUSION: Delayed postoperative retrobulbar hemorrhage may cause total loss of vision in patients with acquired factor VIII antibodies.
Subject(s)
Autoantibodies/blood , Factor VIII/immunology , Hemophilia A/diagnosis , Phacoemulsification/adverse effects , Retrobulbar Hemorrhage/etiology , Aged , Anesthesia, Local , Blindness/etiology , Female , Hemophilia A/therapy , Humans , Partial Thromboplastin TimeABSTRACT
Retrobulbar haemorrhage is an uncommon but well-documented complication of retrobulbar anaesthetic blocks in ocular surgery. Peribulbar anaesthesia has been advocated to be equally effective but safer. The incidence of retrobulbar haemorrhage with peribulbar blocks is very low. We report a case in which a peribulbar anaesthetic for cataract surgery resulted in sight-threatening retrobulbar haemorrhage within the medial rectus muscle and required an anterior orbitotomy and direct decompression of the muscle. The surgery was successful. This case illustrates a potentially serious complication of peribulbar anaesthesia, with the successful outcome achieved by rapid definitive diagnosis and intervention.
Subject(s)
Anesthesia, Local/adverse effects , Needlestick Injuries/etiology , Oculomotor Muscles/injuries , Retrobulbar Hemorrhage/etiology , Aged , Cataract Extraction , Decompression, Surgical , Exophthalmos/etiology , Female , Humans , Intraocular Pressure , Lens Implantation, Intraocular , Needlestick Injuries/diagnostic imaging , Needlestick Injuries/surgery , Oculomotor Muscles/blood supply , Oculomotor Muscles/diagnostic imaging , Retrobulbar Hemorrhage/diagnostic imaging , Retrobulbar Hemorrhage/surgery , Tomography, X-Ray Computed , Visual AcuityABSTRACT
Patients undergoing intraocular surgery are elderly and may have disease or be receiving medication which increases the risk of haemorrhage. We interviewed 1383 consecutive patients scheduled for eye surgery requiring retrobulbar/peribulbar block about their use of non-steroidal anti-inflammatory drugs, oral steroids and warfarin. A history of diabetes mellitus and globe axial length was noted. Medial peribulbar and inferolateral retrobulbar blocks were performed by three specialists and six doctors in training. The ensuing haemorrhages were graded as follows: 1 = spot ecchymosis; 2 = lid ecchymosis involving half of the lid surface area or less; 3 = lid ecchymosis all around the eye, no increase in intraocular pressure; 4 = retrobulbar haemorrhage with increased intraocular pressure. Acetylsalicylic acid was taken by 482 (35%) patients, non-steroidal anti-inflammatory drugs by 260 (19%) and warfarin by 76 (5.5%). Lid haemorrhages (grades 1-3) were observed in 55 patients (4.0%); in 33 of these patients the haemorrhages were spotlike (grade 1). No grade 4 haemorrhages occurred. The preoperative use of acetylsalicylic acid, non-steroidal anti-inflammatory drugs or warfarin, whether or not they had been discontinued, did not predispose to haemorrhage associated with retrobulbar/peribulbar block.
Subject(s)
Anesthesia, Local/adverse effects , Eye Hemorrhage/etiology , Ophthalmologic Surgical Procedures , Retrobulbar Hemorrhage/etiology , Adult , Aged , Aged, 80 and over , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anticoagulants/adverse effects , Aspirin/adverse effects , Eyelid Diseases/etiology , Female , Humans , Male , Middle Aged , Prospective Studies , Risk Factors , Warfarin/adverse effectsSubject(s)
Anesthesia, Local/adverse effects , Postoperative Complications , Anesthetics, Local/administration & dosage , Central Nervous System Diseases/etiology , Humans , Injections , Oculomotor Muscles/injuries , Optic Nerve Injuries/etiology , Orbit/injuries , Prognosis , Retrobulbar Hemorrhage/etiologySubject(s)
Anesthesia, Local/adverse effects , Blindness/etiology , Injections/adverse effects , Needlestick Injuries/etiology , Orbit/injuries , Periosteum/injuries , Retrobulbar Hemorrhage/etiology , Anesthetics, Local/administration & dosage , Blindness/prevention & control , Humans , Needlestick Injuries/prevention & control , Retrobulbar Hemorrhage/prevention & controlSubject(s)
Anesthesia, Local/adverse effects , Blindness/etiology , Injections/adverse effects , Needlestick Injuries/etiology , Orbit/injuries , Periosteum/injuries , Retrobulbar Hemorrhage/etiology , Aged , Aged, 80 and over , Anesthetics, Local/administration & dosage , Cataract Extraction , Female , Humans , Needlestick Injuries/diagnostic imaging , Orbit/diagnostic imaging , Orbit/pathology , Periosteum/diagnostic imaging , Periosteum/pathology , Retrobulbar Hemorrhage/diagnostic imaging , Retrobulbar Hemorrhage/pathology , Tomography, X-Ray Computed , Visual AcuityABSTRACT
PURPOSE: To determine if adequate anesthesia and akinesia could be obtained using an inferonasal quadrant sub-Tenons anaesthesia for cataract surgery. METHODS: The sub-Tenons method of local anaesthesia was used in 50 patients undergoing extracapsular cataract extraction and lens implantation. The technique following was that described by JD Stevens in his study of 50 patients. Posterior sub-Tenons space was approached through a conjunctival incision in the inferonasal quadrant and the anaesthetic solution delivered by an irrigating cannula. The patients were assessed for residual ocular movements just before surgery. Effectiveness of anaesthesia was assessed during surgery using a verbal pain rating score. Scoring was based on the concept of a visual analogue pain score chart. RESULTS: Total akinesia was obtained in 20% patients and total anaesthesia in 24% patients. The remainder of the patients had adequate akinesia and anaesthesia to proceed with and complete the surgery. CONCLUSION: This method provides satisfactory anaesthesia for cataract surgery.