球后麻醉引起对侧眼黑朦(2例报告)

Contralateral Amaurosis After Retrobulbar Anesthesia (Report of 2 cases )

本文报道两例局部球后注射麻醉剂引起对侧眼发生黑朦。1例是64岁的妇女，1例是57岁的男性。黑朦是由于麻醉剂通过视交叉进入蛛网膜下腔到达对侧视神经所致，两例患者的视力在90分钟内都恢复到了术前水平．目前球后注射的眼球位置由以往的向内上转改为向前看或轻度外下转，这样就避免了注射针头意外刺入视神经鞘，而使药物进入蛛网膜下腹内，引起一系列的并发症。

Contralateral amaurosis after retrobulbar injection of local anesthetic agents occurred inthe patients. They were a 64-year-old woman and a 57-year-old man. The amaurosis resulted formmigration of the anesthetic agents to the optic chiasm and contralateral optic nerve via the subarachnoidspace.The yisual acuity of both cases returned to preoperative levels within 90 minutes. A modifiedtechnique in which patients must look straight ahead or slightly downward and outward duringretrobulbar injection, as opposed to the traditional upward and inward positioning of the globe avoidedinadvertent piercing of the sheaths of the optic nerve and injected substances into the subarachnoid space.