Ultrasound detection of iatrogenic injury during peribulbar eye block: a cadaveric study.

Regional Anesthesia and Pain Medicine
Amy SadlerTracey Wilkinson

Abstract

Ophthalmic eye blocks, such as retrobulbar, peribulbar and sub-Tenon's, are traditionally conducted "blind". Complications are rare but potentially devastating. Life-threatening complications include brain stem anesthesia and local anesthetic toxicity, whereas sight-threatening complications include globe perforation, optic nerve damage and ocular muscle damage. Ultrasound permits a view of orbital structures and can be used to guide needle placement. The ultrasound appearances of unintended local anesthetic injection into vital orbital structures have not been documented. This study aimed to record the ultrasound appearances of unintended injection locations. The spherical shape of the eyeballs of three soft-fix Thiel embalmed human cadavers were restored using glycerol. Iatrogenic injury in peribulbar block was then simulated through injection of printers' ink mixed with Thiel embalming fluid. Ultrasound was used to guide the needles and the tips were redirected to lie within the globe, lateral rectus and optic nerve. Ultrasound images were recorded during injection. The orbital cavities were then dissected via a superior approach to record the location and extent of injectate spread. Real-time globe rupture, ocular muscle in...Continue Reading

References

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Dec 10, 2015·Regional Anesthesia and Pain Medicine·Haroldo Maciel CarneiroLeopoldo Magacho

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Citations

Sep 20, 2020·Regional Anesthesia and Pain Medicine·Howard Palte, Steven Gayer

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