DACRYOCYSTORHINOSTOMY IN ELDERLY PATIENTS - REGIONAL ANESTHESIA WITHOUT COCAINE

Elderly patients with nasolacrimal obstruction who are in poor health often pose a special anesthetic and surgical risk. General anesthesia and the use of cocaine packs may be contraindicated because of potenti ally dangerous side effects. Regional block dacryocystorhinostomy has gained popularity in all adult patient groups, but specifically it app ears to be the procedure of choice in elderly patients. It is well sui ted for either hospital-based or ambulatory care. We describe our expe rience with the procedure in 25 consecutive patients (28 procedures), with emphasis on modification of our standard technique to suit region al blockade. Mechanisms of cocaine toxicity in the surgical setting ar e reviewed, and a method of local anesthesia without cocaine nasal pac king is presented.