REGIONAL ANESTHESIA FOR INTRAOCULAR SURGERY

The role of anaesthetists in providing local anaesthesia for intraocul ar surgery has changed over the past decade. No longer confined to the interested few, more and more anaesthetists are involved in monitored care and/or are performing eye block anaesthesia. This reiew summariz es the information related to eye block anaesthesia. The salient featu res of the orbital anatomy important for safe conduct of eye block ana esthesia are described. The techniques for retrobulbar and peribulbar anaesthesia, including facial nerve blocks, anaesthetic mixture, types of needles, and softening the eye are presented. Complications such a s retrobulbar haemorrhage, globe penetration/perforation, visual impai rment, brainstem anaesthesia, muscle injury, and oculocardiac reflex a re explored. The implications of anti-coagulant therapy are examined. The choice between retrobulbar and peribulbar blocks and the role of a naesthetists are discussed.