Medial canthus (caruncle) single injection periocular anesthesia.
We studied 151 consecutive patients scheduled for elective short-duration ophthalmic procedures to assess the efficacy of an alternative approach to periocular anesthesia. Single injection at the medial canthus was performed with a 25-gauge needle. The studied variables were: injected volume, onset time of the block, akinesia (scored on a 12-point scale), adequate surgical anesthesia (scored on a 5-point scale), and need for reinjection. The injected volume of local anesthetic solution was 8.6 +/- 1.7 mL. The onset time of anesthesia was 6.9 +/- 3.0 min, with an akinesia score of 11.6 +/- 1.1 (maximum 12). Additional reinjections were necessary in 14 cases (9.2%). There was a learning curve for the technique, with 8 of the additional injections being performed in the first 30 patients (26.6%), and 6 in the last 121 (4.9%). The surgical score recorded after surgery was 4.8 +/- 0.6 (maximum 5). There were no complications, including injury to the globe, optic nerve, or retina or orbital hematoma. Medial canthus single injection periocular anesthesia appears to be a promising alternative to the usual double injection peribulbar block.
Ripart
J
J
Department d'Anesthésie-Réanimation, Centre Hospitalier et Universitaire de Nimes, France.
Lefrant
J Y
JY
Lalourcey
L
L
Benbabaali
M
M
Charavel
P
P
Mainemer
M
M
Prat-Pradal
D
D
Dupeyron
G
G
Eledjam
J J
JJ
D000368:Aged; D000772:Anesthesia, Local / Q000009:adverse effects / Q000295:instrumentation; D002102:Cadaver; D003287:Contrast Media / Q000008:administration & dosage; D003974:Diatrizoate Meglumine; D017558:Elective Surgical Procedures; D005123:Eye / Q000000981:diagnostic imaging / Q000473:pathology; D015807:Eye Injuries, Penetrating / Q000209:etiology; D005133:Eye Movements / Q000187:drug effects; D005143:Eyelids; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007267:Injections / Q000009:adverse effects / Q000295:instrumentation; D007479:Iopamidol; D008297:Male; D009339:Needles; D009801:Oculomotor Muscles / Q000187:drug effects; D013508:Ophthalmologic Surgical Procedures; D020221:Optic Nerve Injuries; D009916:Orbital Diseases / Q000209:etiology; D011859:Radiography; D012160:Retina / Q000293:injuries; D012449:Safety; D013997:Time Factors
D003287:Contrast Media; D003974:Diatrizoate Meglumine; D007479:Iopamidol