Abstract
Purpose
To present a case of brainstem anaesthesia as a complication of peribulbar anaesthesia.
Clinical features
A 75-yr-old woman received peribulbar anaesthesia for cataract surgery. A few seconds after the block was performed, she had a respiratory arrest, became unconscious, and developed hypertension and tachycardia followed by hypotension and bradycardia. Ventilatory and haemodynamic support were performed before the patient regained adequate spontaneous breathing and normal heart rate and blood pressure.
Conclusion
Peribulbar anaesthesia generally cames a low risk of serious complications. However, respiratory arrest and brainstem anaesthesia may occur as complications of peribulbar blocks.
Résumé
Objectif
Présenter un cas d’anesthésie du tronc cérébral compliquant une anesthésie péribulbaire.
Éléments cliniques
Un bloc péribulbaire était réalisé chez une femine de 75 ans pour l’extraction d’une cataracte. Quelques secondes après l’injection, la patiente cessait de respirer et perdait conscience. Elle devenait hypertendue et tachycarde puts hypotendue et bradycarde. La ventilation et la circulation devaient être supportées jusqu’au retour spontané à la normale.
Conclusion
En général, l’anesthésie péribulbare comporte un faible risque de complications sérieuses. Un arrêt respiratoire par anesthésie du tronc cérébral est toujours possible.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Knapp H. On cocaine and its use in ophthalmic and general surgery. Arch Ophthalmol 1884; 13: 402–48.
Davis DB II, Mandel MR. Posterior peribulbar anesthesia: an alternative to retrobulbar anesthesia. J Cataract Refract Surg 1986; 12: 182–4.
Wong DHW. Regional anaesthesia for intraocular surgery. Can J Anaesth 1993; 40: 635–57.
Murdoch IE. Peribulbar versus retrobulbar anaesthesia. Eye 1990; 4: 445–9.
Ortiz M, Valls R, Vallès J, Blanco D, Vidal F. Topography of peribulbar anesthesia. Reg Anesth 1995; 20: 337–42.
Kimble JA, Morris RE, Witherspoon CD, Feist RM. Globe perforation from peribulbar injection (Letter). Arch Ophthalmol 1987; 105: 749.
Zahl K, Nassif JM, Meltzer MA, Som P. Simulated peribulbar injection of anesthetic. Ann Ophthalmol 1991; 23: 114–7.
Pannu JS. Peribulbar vs. retrobulbar anesthetic techniques (Letter). Ophthalmic Surg 1990; 21: 147–50.
Drysdale DB. Experimental subdural retrobulbar injection of anesthetic. Ann Ophthalmol 1984; 16: 716–8.
Unsöld R, Stanley JA, DeGroot J. The CT-topography of retrobulbar anesthesia. Graefes Arch Klin Exp Ophthalmol 1981; 217: 125–36.
Liu C, Youl B, Moseley I. Magnetic resonance imaging of the optic nerve in extremes of gaze. Implications for the positioning of the globe for retrobulbar anaesthesia. Br J Ophthalmol 1992; 76: 728–33.
Hamilton RC, Gimbel HV, Strunin L. Regional anaesthesia for 12,000 cataract extraction and intraocular lens implantation procedures. Can J Anaesth 1988; 35: 615–23.
Whitsett JC, Balyeat HD, McClure B. Comparison of one-injection-site peribulbar anesthesia and retrobulbar anesthesia. J Cataract Refract Surg 1990; 16: 243–5.
Hamilton RC. Brain-stem anesthesia as a complication of regional anesthesia for ophthalmic surgery. Can J Ophthalmol 1992; 27: 323–5.
Rosenblatt RM, May DR, Barsoumian K. Cardiopulmonary arrest after retrobulbar block. Am J Ophthalmol 1980; 90: 425–7.
Meyers EF, Ramirez RC, Boniuk I. Grand mal seizures after retrobulbar block., Arch Ophthalmol 1978; 96: 847.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gomez, R.S., Andrade, L.O.F. & Costa, J.R.R. Brainstem anaesthesia after peribulbar anaesthesia. Can J Anaesth 44, 732–734 (1997). https://doi.org/10.1007/BF03013387
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03013387