Try out PMC Labs and tell us what you think. Learn More. Performing safe and effective regional anaesthesia for ophthalmic surgery is an important skill for anaesthetic and ophthalmologic practitioners. Akinetic sharp-needle blocks are generally safe but rare, sight and life threatening complications occur. Sub-Tenon's block using a blunt canula provides akinesa and is a safer alternative but serious complications have been reported. This review provides an introduction to the relevant anatomy, local anaesthetic drugs and commonly used techniques and a practical guide to their safe performance.
Head and Neck Regional Anesthesia Techniques
Ophthalmic surgery is one of the most common surgical procedures requiring anesthesia in developed countries. Ophthalmic anesthesia offers insights into some fundamental principles of good anesthetic practice, especially in the conduct of local and regional nerve blocks. Clinical strategies to minimize patient movement during eye surgery are essential. Historically, eye surgeons favored general anesthesia GA , which usually provided akinesia through neuromuscular blockade and low intraocular pressure. However, these conditions are not always achieved under GA.
Local and Regional Anesthesia for Ophthalmic Surgery
The greater occipital nerve arises from between the first and second cervical vertebrae, along with the lesser occipital nerve. It supplies sensation to the skin along the back of the scalp to the top of the head. Sometimes, when the occipital nerve is irritated, the pain of this irritation is felt near the eye of the same side of the head. This is known as referred pain. These nerves may also contribute to headaches.
Samuel DeMaria, Jr. The head and neck have a rich nerve supply with reliably identifiable surface and bony landmarks. This makes administering regional anesthesia for head and neck surgical procedures practical and effective. Although novel for otolaryngologic surgical procedures, the use of regional anesthesia is commonplace for dental and oral-maxillofacial procedures.