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Online ISSN 1827-1596
Gayer S. 1, Kumar C. M. 2
1 Department of Anesthesiology, and Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA;
2 Academic Department of Anesthesia, The James Cook University Hospital, Middlesbrough, UK
There is substantial national and international variation in the conduct of anesthesia for ophthalmic surgical procedures. Ophthalmic regional anesthetic techniques include traditional needle-based blocks, such as intraconal or extraconal injections; sub-Tenon’s blocks which can be accomplished with needles, but are more commonly performed with blunt cannulae; and topical anesthesia. Needle-based techniques are generally safe although rare, serious sight- and life-threatening complications may occur. In recent years, a renewed interest in sub-Tenon’s and topical anesthesia has emerged. Currently there is no absolutely safe ophthalmic regional block. It is essential that those who are involved in the care of ophthalmic patients have a thorough knowledge of the approaches employed and their associated risks and benefits. This review article outlines the relevant anatomy, commonly used techniques and their safe performance.