Life-threatening complication of retrobulbar block. A hypothesis.
After routine retrobulbar injection of a 4-ml 1:1 mixture of 0.75% bupivacaine, and of 2% lidocaine and one ampule of hyaluronidase for cataract extraction, the patient sustained bilateral opthalmoplegia, blindness, central respiratory arrest, and loss of consciousness. Neurologic examination shortly thereafter suggests that this may be a result of accidental subarachnoid injection. Prompt recognition and treatment reversed a life-threatening situation.
D001766:Blindness / Q000209:etiology; D002045:Bupivacaine; D002387:Cataract Extraction; D005123:Eye; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects* / Q000379:methods; D009886:Ophthalmoplegia / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology; D014474:Unconsciousness / Q000209:etiology
D002045:Bupivacaine