Preliminary experience of combined peri- and retrobulbar block in surgery for penetrating eye injuries.
OBJECTIVE
Regional anaesthesia has not been recommended as an anaesthetic method for penetrating eye injuries because it is suspected to aggravate the injury already present. After having successfully managed the treatment of a penetrating eye injury under combined peri- and retrobulbar block in an ASA IV patient, it was decided to evaluate this anaesthetic method further in the treatment of such emergency cases.


METHODS
Twenty adult patients with penetrating eye injuries with a maximum wound length of 8 mm extending up to 4 mm posteriorly from the limbus were operated on under combined peri- and retrobulbar anaesthesia. Eighteen patients receiving general anaesthesia served as controls.


RESULTS
The mean (range) volume injected for a satisfactory peribulbar retrobulbar block was 7.4 (6.5-8.0) mL, six patients needed an additional retrobulbar injection before surgery (2.9, range 2-4, mL). All patients receiving regional anaesthesia were satisfied with the anaesthetic method and the surgeons considered the surgical conditions as good. No problems relating to local anaesthesia were observed or reported by any of the patients.


CONCLUSIONS
In the hands of an experienced anaesthesiologist and under certain conditions, regional anaesthesia appears to be suitable for adult patients having penetrating eye injuries.
Niemi-Murola
L
L
Helsinki University Hospital, Department of Anaesthesiology and Intensive Care Medicine, Helsinki, Finland. leila.niemi-murola@hus.fi
Immonen
I
I
Kallio
H
H
Maunuksela
E L
EL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction / Q000379:methods*; D000768:Anesthesia, General; D019162:Anesthetics, Combined / Q000627:therapeutic use*; D015807:Eye Injuries, Penetrating / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D019162:Anesthetics, Combined