title: Prevention and management of complications of regional orbital anesthesia.
abstract: The majority of ophthalmic procedures are performed under regional anesthesia, but the proximity of important structures such as the blood vessels, optic nerve and the brainstem lead to increased risks associated with these blocks. The most serious of these complications is brainstem anesthesia. As the number of outpatient freestanding surgical centers increase, the significance of these potential complications is expected to increase from orbital blocks for ocular surgical procedures such as cataract removal and vitrectomy. An understanding of these complications, which may sometimes be life-threatening, are thus vital to the anesthesia practitioner. Procedural improvements include a close evaluation of the precise anatomy of the region, with particular attention to injection sites, depth of injection, position of the globe, and techniques to avoid nerve damage and accidental injection into surrounding structures, including blood vessels, globe and cerebrospinal fluid. This literature review emphasizes the importance of the prevention, recognition and management of these complications, which includes the extremely serious complication of brainstem anesthesia.
authors: Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA.
authors: Nalini
authors: N
authors: Vadivelu
authors: Yili
authors: Y
authors: Huang
authors: Alan David
authors: AD
authors: Kaye
authors: Vijay
authors: V
authors: Kodumudi
authors: Alice
authors: A
authors: Kai
authors: Ron A
authors: RA
authors: Adelman
mesh_terms: D000765:Anesthesia, Conduction / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D013508:Ophthalmologic Surgical Procedures; D009915:Orbit / Q000033:anatomy & histology / Q000098:blood supply / Q000294:innervation
chemical_list: D000779:Anesthetics, Local