Technique for Retrobulbar Anesthetic Injection for Eye Surgery
To perform a safe cataract surgery and to keep the patient comfortable and painfree, we need to give a sufficient level of anesthesia. For beginning surgeons, giving a retrobulbar injection of anesthetic is a good way to achieve both anesthesia and akinesia. For experienced cataract surgeons, using a combination of topical anesthesia and intracameral anesthesia tends to work the best. I favor topical tetracaine eye drops combined with preservativefree dilute (1 or less) lidocaine given in the anterior chamber. For a resident who is starting to learn cataract surgery, a higher level of anesthesia such as a retrobulbar block should be given. The agents used are typically lidocaine 1 (Xylocaine), bupivicaine 0. 75(Marcaine), or a combination of the two. The lidocaine tends to start working faster and lasts for a shorter period of time compared to the bupivicaine which can last for many hours more. The anesthetic is drawn into a 5 or 10 cc syringe and an Atkinson retrobulbar needle is used. T
|
|