What is the difference between Peribulbar and retrobulbar block?
What is the difference between Peribulbar and retrobulbar block?
Peribulbar anaesthesia is performed by injecting the anaesthetic drug in the orbit around the equator of the eye ball (globe). Retrobulbar anaesthesia is performed by injecting the anaesthetic drug in the orbit further back behind the eye ball, which is near the nerves that control eye movement and sensation.
Which ocular block carries the highest risk?
A retrobulbar block is more efficient in producing anaesthesia and akinesia and has a faster onset of action. However, it carries a higher risk of rare, yet serious, complications, such as globe perforation, retrobulbar haemorrhage, and injection of the anaesthetic into the cerebrospinal fluid (CSF).
What is retrobulbar injection?
Background. Retrobulbar block is type of regional anesthetic nerve block used in intraocular surgery. In this technique, local anesthetic is injected into the retrobulbar space, the area located behind the globe of the eye.
What is Peribulbar?
Peribulbar block involves injections above and below the orbit, with local anesthetic deposited in the orbicularis oculi muscle. This technique blocks the ciliary nerves, as well as CN III and VI, but does not block the optic nerve (CN II).
When is retrobulbar block used?
Retrobulbar block is used for any type of eye surgery or procedure requiring eyeball (globe) anesthesia and eye muscle paralysis, such as: Cataract surgery. Corneal surgery. Refractive surgery.
How long does a Peribulbar block last?
Depending on the type of anesthetic, a block may last over four hours with a mixture of lidocaine 1% and bupivicaine 0.375%. Addition of hyaluronidase to the anesthetic mix improves penetration of anethesia (Anesth Analg 2000 Oct;91(4):934-7.) Clean the lower lid with an alcohol wipe.
Is retrobulbar injection safe?
Conclusions: Retrobulbar injection using 10 mL lidocaine is safe in normal eyes of adult horses, but carries risk in structurally compromised or glaucomatous eyes due to transient IOP increase.
What is a retrobulbar hematoma?
Retrobulbar hematoma is the phenomenon of blood collecting in the retrobulbar space behind the globe. Although it is not common, it is a serious condition that can lead to blindness.
What anesthetic is used for a retrobulbar block?
Anesthetic Agent The most used combination is the Lidocaine 2% with bupivacaine 0.75%. In general the use of epinephrine or other vasoconstrictors is avoided to prevent ciliary or ophthalmic artery spasm and permanent vision loss, except in cases of enucleation or evisceration.
What are the risks of retrobulbar block?
The literature describes several complications of retrobulbar blocks, including chemosis, bruising, retrobulbar hemorrhage, globe penetration and perforation, optic nerve damage and atrophy, ex- traocular muscle malfunction and injury, brain stem anesthesia, globe ischemia, and complications of nerve VII.