Abstract
A case of a severe but brief period of shivering following a retrobulbar block (RBB) is presented. The shivering occurred within two minutes after completion of the RBB and subsided gradually within five minutes, without specific treatment. The patient remained conscious during the episode of shivering. The shivering was so abrupt and severe as to be misjudged as a seizure, but its onset appeared to be slower than a seizure. The mechanism of shivering appeared to be the central spread of local anaesthetic solution into the brain stem, along the optic nerve. Shivering may be a warning sign of brain stem anaesthesia and demands special care to anticipate life-threatening complications.
Résumé
On décrit le cas ďun patient qui a présenté une brève et sévère épisode de frissons à la suite ďun block rétrobulbaire (RBB). Ľépisode de frissons est survenu deux minutes après le RBB et s’est estompé graduellement après cinq minutes sans aucun traitement spécifique. Le patient est resté conscient durant cet épisode. Les frissons étaient soudains et sévères pour être confondus avec des convulsions, cependant le début de leur installation était plus lent que celui des convulsions. Le mécanisme de ce frisson apparaît comme étant ľextension centrale de la solution ďanesthésie locate le long du nerf optique. Le frisson peut être un signe avertisseur ďune anesthésie du tronc cérébral et demande des soins spéciauz afin ďéviter des complications mortelles.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Donlon JV. Anesthesia for Eye, Ear, Nose and Throat.In: Miller RD (Ed) Anesthesia 2nd Ed. NY: Churchill Livingstone, 1986, pp 1837–58.
Chang JL, Gonzalez-Abola E, Larson CE, Lobes L. Brain stem anesthesia following retrobulbar block. Anesthesiology 1984; 61: 789–90.
Follette JW, LoCascio JA. Bilateral amaurosis following unilateral retrobulbar block. Anesthesiology 1985; 63: 237–8.
Hamilton RC. Brain stem anesthesia following retrobulbar blockade. Anesthesiology 1985; 63: 688–90.
Rosenblatt RM, May DR, Barsoumian K. Cardiopulmonary arrest after retrobulbar block. Am J Ophthalmology 1980; 90: 425–7.
Smith JL. Retrobulbar marcaine can cause respiratory arrest. J Clin Neurophthalmology 1972; 1: 171–2.
Wittpen JR, Rapoza P, Sternberg P, Kuwashima L, Saklad J, Patz A. Respiratory arrest following retrobulabur anesthesia. Ophthalmology 1986; 93: 867–79.
Antoszyk AN, Buckley EG. Contralateral decreased visual acuity and extraocular muscle palsies following retrobulbar anesthesia. Ophthalmology 1986; 93: 462–5.
Meyers EF, Ramirez RC, Bonink I. Grand mal seizures after retrobulbar block. Arch Ophthalmol 1978; 96: 847.
Lombardi G. Radiology in neurophthalmology. Baltimore: Williams and Wiikins 1967, pp. 6–8.
Kepes ER, Foldes FF. Transient abducens paralysis following therapeutic nerve blocks of head and neck. Anesthesiology 1973; 38: 393–4.
Nique TA, Bennett CR. Inadvertent brainstem anesthesia following extra oral trigeminal V2-V3 blocks. Oral Surgery 1981; 51: 468–70.
Byers B. Blindness secondary to steroid injection into the nasal turbinates. Arch Ophthalmol 1979; 97: 79.
Amini-Sereshki L. Brainstem control of shivering in the cat. I. Inhibition. Am J Physiol 1977; 232 (Regulatory Integrative Comp Physiol 1): R190–7.
Amini-Sereshki L. Brainstem control of shivering in the cat. H. Facilitation. Am J Physiol 1977; 232 (Regulatory Integrative Comp Physiol 1): R198–202.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lee, D.S., Kwon, N.J. Shivering following retrobulbar block. Can J Anaesth 35, 294–296 (1988). https://doi.org/10.1007/BF03010633
Issue Date:
DOI: https://doi.org/10.1007/BF03010633