Simulated peribulbar injection of anesthetic.
To evaluate whether intracranial spreading of a local anesthetic might occur after a peribulbar injection, we did simulated peribulbar anesthetic injections with radiopaque dye into two cadaver heads. Using a standard and modified peribulbar injection with a 25-gauge needle, the four orbits were injected with 8 mL of dye. Computed tomography revealed that the dye spread intraconally and intracranially. In one case the dye was seen tracking along the optic nerve sheath. Since intracranial spreading of a local anesthetic may be associated with adverse sequelae (i.e., brainstem anesthesia), we urge caution and vigilance after both peribulbar and retrobulbar anesthetic injections to prevent cardiopulmonary compromise.
Published In/Presented At
Zahl, K., Nassif, J. M., Meltzer, M. A., & Som, P. (1991). Simulated peribulbar injection of anesthetic. Annals of ophthalmology, 23(3), 114–117.
Anesthesiology | Medicine and Health Sciences
Department of Anesthesiology