BACKGROUND Apnea caused by retrobulbar anesthesia is a very rare but severe complication during ophthalmic surgery.CASE SUMMARY We report a rare case of apnea caused by retrobulbar anesthesia,and emergency resuscitati...BACKGROUND Apnea caused by retrobulbar anesthesia is a very rare but severe complication during ophthalmic surgery.CASE SUMMARY We report a rare case of apnea caused by retrobulbar anesthesia,and emergency resuscitation was used.A 74-year-old female patient was diagnosed with rhegmatogenous retinal detachment in the right eye and planned to undergo vitrectomy under retrobulbar anesthesia.After the retrobulbar anesthesia in her right eye,she became unconscious and apneic.It was suggested that she had developed brainstem anesthesia.Assisted ventilation was initiated.Atropine 0.5 mg,epinephrine 1 mg,ephedrine 30 mg,and lipid emulsion were given.Five minutes later,her consciousness and breathing gradually returned,but with uncertain light perception in her right eye.Alprostadil 20μg was given,and after 2 h her visual acuity resumed to the preoperative level.CONCLUSION Brainstem anesthesia is a serious complication secondary to retrobulbar anesthesia.Medical staff should pay attention to the identification of brainstem anesthesia and be familiar with the emergency treatment for this complication.展开更多
BACKGROUND To report the possible reasons for needle perforation and complications related to perforation,as well as the clinical management of subretinal hemorrhage(SRH)during retrobulbar injection.CASE SUMMARY A 65-...BACKGROUND To report the possible reasons for needle perforation and complications related to perforation,as well as the clinical management of subretinal hemorrhage(SRH)during retrobulbar injection.CASE SUMMARY A 65-year-old female was scheduled to undergo pars plana vitrectomy(PPV)in her left eye for rhegmatogenous retinal detachment(RRD).During retrobulbar anesthesia,needle perforation of the globe occurred.Massive SRH in the inferotemporal quadrant together with vitreous hemorrhage were observed.The patient underwent PPV combined with retinotomy for removal of the massive SRH.After earlier surgical intervention,successful reattachment of the retina was achieved.CONCLUSION Inadvertent globe penetration during retrobulbar anesthesia is associated with a poor prognosis and may result in blindness.Timely detection and earlier intervention may be beneficial.展开更多
Retrobulbar anesthesia (block) is used for many ocular surgeries, whereas it is well known that this procedure has complications such as for retrobulbar hemorrhage, globe perforation, optic nerve injury and brain stem...Retrobulbar anesthesia (block) is used for many ocular surgeries, whereas it is well known that this procedure has complications such as for retrobulbar hemorrhage, globe perforation, optic nerve injury and brain stem anesthesia. In this report, we present a unique case in the literature of isolated exudative retinal detachment (RD) secondary to iatrogenic retrobulbar hemorrhage. A 73-year-old woman underwent retrobulbar block for combined phaco-vitrectomy. Immediately after the injection, progressive proptosis was recognized. The globe was decompressed and she underwent combined phaco-vitrectomy after stabilization of the eye on the same day. At the be-ginning of the vitrectomy, a dome shaped serous RD was observed in the infero-temporal quadrant. Peripheral exploration was performed, whereas there was no retinal tear or hole. On the first day postoperatively, serous RD was disappeared. In conclusion, this report suggests that increased intraorbital pressure secondary to iatrogenic retrobulbar hemorrhage might lead exudative RD.展开更多
文摘BACKGROUND Apnea caused by retrobulbar anesthesia is a very rare but severe complication during ophthalmic surgery.CASE SUMMARY We report a rare case of apnea caused by retrobulbar anesthesia,and emergency resuscitation was used.A 74-year-old female patient was diagnosed with rhegmatogenous retinal detachment in the right eye and planned to undergo vitrectomy under retrobulbar anesthesia.After the retrobulbar anesthesia in her right eye,she became unconscious and apneic.It was suggested that she had developed brainstem anesthesia.Assisted ventilation was initiated.Atropine 0.5 mg,epinephrine 1 mg,ephedrine 30 mg,and lipid emulsion were given.Five minutes later,her consciousness and breathing gradually returned,but with uncertain light perception in her right eye.Alprostadil 20μg was given,and after 2 h her visual acuity resumed to the preoperative level.CONCLUSION Brainstem anesthesia is a serious complication secondary to retrobulbar anesthesia.Medical staff should pay attention to the identification of brainstem anesthesia and be familiar with the emergency treatment for this complication.
文摘BACKGROUND To report the possible reasons for needle perforation and complications related to perforation,as well as the clinical management of subretinal hemorrhage(SRH)during retrobulbar injection.CASE SUMMARY A 65-year-old female was scheduled to undergo pars plana vitrectomy(PPV)in her left eye for rhegmatogenous retinal detachment(RRD).During retrobulbar anesthesia,needle perforation of the globe occurred.Massive SRH in the inferotemporal quadrant together with vitreous hemorrhage were observed.The patient underwent PPV combined with retinotomy for removal of the massive SRH.After earlier surgical intervention,successful reattachment of the retina was achieved.CONCLUSION Inadvertent globe penetration during retrobulbar anesthesia is associated with a poor prognosis and may result in blindness.Timely detection and earlier intervention may be beneficial.
文摘Retrobulbar anesthesia (block) is used for many ocular surgeries, whereas it is well known that this procedure has complications such as for retrobulbar hemorrhage, globe perforation, optic nerve injury and brain stem anesthesia. In this report, we present a unique case in the literature of isolated exudative retinal detachment (RD) secondary to iatrogenic retrobulbar hemorrhage. A 73-year-old woman underwent retrobulbar block for combined phaco-vitrectomy. Immediately after the injection, progressive proptosis was recognized. The globe was decompressed and she underwent combined phaco-vitrectomy after stabilization of the eye on the same day. At the be-ginning of the vitrectomy, a dome shaped serous RD was observed in the infero-temporal quadrant. Peripheral exploration was performed, whereas there was no retinal tear or hole. On the first day postoperatively, serous RD was disappeared. In conclusion, this report suggests that increased intraorbital pressure secondary to iatrogenic retrobulbar hemorrhage might lead exudative RD.
