Simulated peribulbar injection of anesthetic

Ann Ophthalmol. 1991 Mar;23(3):114-7.

Abstract

To evaluate whether intracranial spreading of a local anesthetic might occur after a peribulbar injection, we did simulated peribulbar anesthetic injections with radiopaque dye into two cadaver heads. Using a standard and modified peribulbar injection with a 25-gauge needle, the four orbits were injected with 8 mL of dye. Computed tomography revealed that the dye spread intraconally and intracranially. In one case the dye was seen tracking along the optic nerve sheath. Since intracranial spreading of a local anesthetic may be associated with adverse sequelae (i.e., brainstem anesthesia), we urge caution and vigilance after both peribulbar and retrobulbar anesthetic injections to prevent cardiopulmonary compromise.

MeSH terms

  • Anesthetics / pharmacokinetics
  • Diatrizoate Meglumine / pharmacokinetics*
  • Humans
  • Injections
  • Models, Biological
  • Optic Nerve / diagnostic imaging
  • Orbit / diagnostic imaging
  • Orbit / metabolism*
  • Skull / diagnostic imaging
  • Tomography, X-Ray Computed

Substances

  • Anesthetics
  • Diatrizoate Meglumine