title: [Amaurosis and contralateral cranial nerve pairs III and VI paralysis after peribulbar block - case report].
abstract: OBJECTIVE
  Peribulbar anesthesia has emerged as a safer option compared with intraconal retrobulbar block. Still, peribulbar anesthesia may not be considered without risk. Numerous complications have been described when performing this technique. This report aims to describe a rare case of amaurosis and contralateral paralysis while attempting to perform a peribulbar anesthesia.
  
  
  METHODS
  Male patient, 75-year old, physical status ASA II, undergoing cataract surgery by phacoemulsification with intraocular lens implantation. Sedated with fentanyl and midazolam and subjected to peribulbar anesthesia. There were no complications during surgery. After finishing the procedure, the patient reported lack of vision in the contralateral eye. Akinesia of the muscles innervated by the cranial nerve pairs III and VI, ptosis, and medium-sized pupils unresponsive to light stimulus were observed. Four hours after anesthesia, complete recovery of vision and eyelid and eyeball movements was seen in the non-operated eye.
  
  
  CONCLUSIONS
  During peribulbar anesthesia, structures located in the intraconal space can be accidentally hit leading to complications such as described in the above report. Following the technical guidelines and using appropriate size needles may reduce the risk of such complication, but not completely.
authors.affiliation: Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde, Departamento de Cirurgia, Sorocaba, SP, Brasil. Electronic address: fabio.leme@hotmail.com.
authors.forename: Fábio Caetano Oliveira
authors.initials: FCO
authors.lastname: Leme
authors.affiliation: Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde, Departamento de Cirurgia, Sorocaba, SP, Brasil.
authors.forename: Eduardo Toshiyuki
authors.initials: ET
authors.lastname: Moro
authors.affiliation: Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde, Departamento de Cirurgia, Sorocaba, SP, Brasil.
authors.forename: Alexandre Alberto Fontana
authors.initials: AAF
authors.lastname: Ferraz
keywords: Amaurose; Amaurosis; Anestesia peribulbar; Bloqueio retrobulbar; Complications; Complicações; Contralaterais; Contralateral; Paralisia; Paralysis; Peribulbar anesthesia; Retrobulbar block