• The Korean Journal of Pain
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• 제22권3호
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• pp.241-244
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• 2009

Retrobulbar hematoma can arise from orbital trauma and periorbital or intraorbital procedures, and it can result in several morbidities including vision loss. Making the immediate diagnosis and performing decompression of the retrobulbar hematoma are crucial for preventing serious morbidities such as permanent vision loss. We present here a case of temporary vision loss that was due to iatrogenic retrobulbar hematoma in a patient who received infraorbital nerve block for the treatment of trigeminal neuralgia. A 70-year-old woman with trigeminal neuralgia was treated with infraorbital nerve block. Just after the procedure she experienced acute periorbital swelling, proptosis and worsening visual acuity. Immediate orbital computed tomography was done, and this revealed a retrobulbar hematoma. The patient underwent lateral canthotomy with cantholysis and administration of dexamethasone and mannitol. Improvement of visual acuity began 3 hours after these procedures. Her visual acuity was greatly improved 12 days after admission.

• 한국임상수의학회지
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• 제26권5호
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• pp.476-479
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• 2009

Enucleation of a 9-year-old, spayed female Pekingese's right eye was scheduled because of recurrent eyeball rupture caused by chronic corneal ulcer and descemetocele. Scoliosis of the thoracic vertebra was observed on thoracic radiography. Complete blood count, electrolytes, serum chemistry profiles were within normal ranges except of alkaline phosphatase, which was markedly improved, compared with that of five months ago. Severe respiratory sinus arrhythmia was observed before induction of anesthesia, it disappeared after induction. Retrobulbar block was performed with 0.5% bupivacaine, 2% lidocaine, 0.1% epinephrine combination (4 : 1 : 0.2 ratio of volume) before start of surgery. After retrobulbar block, heart rate decreased from 110 to 76 beats/min and sinus arrhythmia recurred. It was considered as oculocardiac reflex caused by increase of intraorbital pressure from retrobulbar block, atropine (0.025 mg/kg, IV) was administered and intermittent positive pressure ventilation was started. Three minutes after atropine administration, abnormal waveform of the electrocardiograph was appeared, it suspected as ventricular or supraventricular tachycardia, so lidocaine (2 mg/kg, IV) was administered. Then, heart rate was maintained around 130 beats/min, and the surgery was finished without the other problems. Although, retrobulbar block is performed to provide analgesia and to prevent oculocardiac reflex in ophthalmic surgery, occasionally it could induce oculocardiac reflex by infiltrated volume.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2008년도 추계학술대회
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• pp.180-180
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• 2008

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권2호
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• pp.93-96
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• 2015

Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.

• Journal of Veterinary Science
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• 제22권2호
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• pp.22.1-22.9
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• 2021

Background: Standing surgery in horses combining intravenous sedatives, analgesics and local anaesthesia is becoming more popular. Ultrasound guided (USG) peribulbar nerve block (PB) has been described in dogs and humans for facial and ocular surgery, reducing the risk of complications versus retrobulbar nerve block (RB). Objective: To describe a technique for USG PB in horse cadavers. Methods: Landmarks and PB technique were described in two equine cadaver heads (Phase 1), with computed tomography (CT) imaging confirming contrast location and spread. In Phase 2, ten equine cadaver heads were randomised to two operators naive to the USG PB, with moderate experience with ultrasonography and conventional "blind" RB. Both techniques were demonstrated once. Subsequently, operators performed five USG PB and five RB each, unassisted. Contrast location and spread were evaluated by CT. Injection site success was defined for USG PB as extraconal contrast, and for RB intraconal contrast. Results: Success was 10/10 for USG PB and 0/10 for RB (p < 0.001). Of the RB injections, eight resulted in extraconal contrast and two in the masseter muscle (p = 0.47). Conclusions: The USG PB had a high injection site success rate compared with the RB technique; however, we cannot comment on clinical effect. The USG technique was easily learnt, and no potential complications were seen. The USG PB nerve block could have a wide application for use in horses for ocular surgeries (enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia) due to reduced risk of iatrogenic damage. Further clinical studies are needed.