RESUMEN
We describe a simple technique that reduces the effect of blepharospasm in the presence of sub-Tenon's or topical anesthesia without the administration of a lid block or a reduction in adequate analgesia.
Asunto(s)
Anestesia Local/métodos , Extracción de Catarata/métodos , Blefaroespasmo/prevención & control , Extracción de Catarata/instrumentación , Humanos , Equipo Quirúrgico , Instrumentos QuirúrgicosRESUMEN
BACKGROUND: Most personal defense sprays contain o-chlorobenzylidene malononitrile (CS), w-chloroacetophenone (CN), oleoresin capsicum (OC), or a combination of these ingredients as the active agent. They are designed to incapacitate by causing acute ocular irritation, lacrimation, conjunctivitis, blepharospasm, and mild to moderate respiratory distress. METHODS: To assess the ocular effects of sprays containing OC as the active agent. Snellen visual acuities and anterior segment appearances of 22 police officers were determined before and after spray exposure. To assess the effects of OC spray contamination on soft contact lenses, four brands of lenses were sprayed and cleaned twice with an alcohol-based cleaner. Gas chromatography was used to search for residual OC in the lenses. RESULTS: All officers experienced intense blepharospasm, lacrimation, conjunctivitis, and incapacitation as the result of spray exposure. Acute effects lasted about 5 to 10 min, with relatively complete recovery occurring in about 30 to 60 min. All had significant conjunctivitis, and some had water-drop-shaped corneal defects that stained with fluorescein. These defects resolved within 24 hours without treatment. OC residue was found to be present in the soft lenses that had been sprayed and cleaned twice. CONCLUSIONS: Optometrists can manage uncomplicated spray exposure patients by directing at-home irrigation with water, and following up with an in-office examination. Soft lenses contaminated by OC spray should be discarded.
Asunto(s)
Blefaroespasmo/inducido químicamente , Quemaduras Químicas/etiología , Conjuntivitis/inducido químicamente , Quemaduras Oculares/inducido químicamente , Irritantes/efectos adversos , Enfermedades del Aparato Lagrimal/inducido químicamente , Extractos Vegetales/efectos adversos , Aerosoles , Blefaroespasmo/prevención & control , Blefaroespasmo/terapia , Quemaduras Químicas/prevención & control , Quemaduras Químicas/terapia , Capsicum/efectos adversos , Cromatografía de Gases , Conjuntivitis/prevención & control , Conjuntivitis/terapia , Lentes de Contacto , Quemaduras Oculares/prevención & control , Quemaduras Oculares/terapia , Dispositivos de Protección de los Ojos , Humanos , Enfermedades del Aparato Lagrimal/prevención & control , Enfermedades del Aparato Lagrimal/terapia , Plantas Medicinales , Salicilatos/efectos adversos , Agudeza Visual/efectos de los fármacosRESUMEN
Traditionally, local anaesthesia for cataract surgery requires retrobulbar blockade to be supplemented with a facial nerve block in order to prevent blepharospasm. In this study retrobulbar block using a larger volume of local anaesthetic without facial nerve block is compared with the combined technique in 50 patients. The adequacy of the two techniques was assessed by the surgeon according to eye motility (in four different planes), lid motility and eye softness and an overall surgical assessment was made at the end of the procedure. Blepharospasm did not occur. The operating conditions were equally good in both groups (p > 0.05). These results suggest that good operating conditions for cataract operations can be provided by retrobulbar block alone without supplementary facial nerve block.