What is Peribulbar and retrobulbar?
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.
What is a retrobulbar injection?
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.
How do you perform a retrobulbar block?
Slowly inject 2 to 4 ml of anesthetic and remove needle. With the eye closed apply resistance to the volume injected apply pressure with gauze or (historically) a Honan balloon at 20 to 30 mmHg for 5 minutes to prevent a hemorrhage and increase diffusion of the anesthetic agent. Monitor for retrobulbar hemorrhage.
How does Peribulbar block work?
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.
What is retrobulbar pain?
What Is It? Retrobulbar neuritis is a form of optic neuritis in which the optic nerve, which is at the back of the eye, becomes inflamed. The inflamed area is between the back of the eye and the brain.
Is a retrobulbar block painful?
Retrobulbar blocks. They block the ciliary nerves, ciliary ganglion, and cranial nerves III, IV and VI. They’re usually deeper than peribulbar blocks and require less volume to attain the goal of no movement and no pain.
What is Retrobulbar haemorrhage?
Retrobulbar hemorrhage (RBH) is a rapidly progressive, sight-threatening emergency that results in an accumulation of blood in the retrobulbar space.
How do you administer Peribulbar anaesthesia?
Peribulbar block: the needle is inserted through the fornix below the lateral limbus after the lower fornix was exposed (by pulling the lower lid down gently). Instil one drop of topical anaesthetic eye drops. Insert the needle through the fornix below the lateral limbus.
Is retrobulbar block painful?
What is the best treatment for retrobulbar neuritis?
Many cases improve without treatment. Sometimes, a corticosteroid medication, such as intravenous methylprednisolone, is used to treat retrobulbar neuritis.
How long does retrobulbar block last?
Depending on the type of anesthetic used, a retrobulbar block may be short-acting, lasting about 30 minutes, or long-acting, lasting about 6-8 hours.
What is retrobulbar anesthesia?
Retrobulbar anesthesia is a type of regional anesthetic nerve block in the retrobulbar space, located behind the globe of the eye. The technique was first described in 1884 by Herman Knapp.
What are the alternatives to retrobulbar anesthesia for cataract surgery?
Posterior peribulbar anesthesia: an alternative to retrobulbar anesthesia. J Cataract Refract Surg. 1986 Mar;12(2):182-4. [PubMed: 3701637] 15. Hessemer V. [Peribulbar anesthesia versus retrobulbar anesthesia with facial nerve block. Techniques, local anesthetics and additives, akinesia and sensory block, complications]. Klin Monbl Augenheilkd.
What are the different types of regional anesthesia?
The types of regional anesthesia are specific nerve branch blocks (e.g. supratrochlear, infraorbital), retrobulbar, peribulbar, and subtenon. Retrobulbar anesthesia is a type of regional anesthetic nerve block in the retrobulbar space, located behind the globe of the eye.
What are the possible complications of retrobulbar block?
Complications from retrobulbar block occur in 1-3%, ranging from mild to severe. The following are the complications described in literature: Perforation (needle in eyeball) can cause blindness, but is rare. Mechanisms include choroidal hemorrhage, retinal detachment, vitreous hemorrhage, or needle trauma to retina/nerve and associated scarring.
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