Van lint facial block
Ophthalmic surgery is one of the most common surgical procedures requiring anesthesia in developed countries. Ophthalmic anesthesia offers insights into some fundamental principles of good anesthetic practice, especially in the conduct of local and regional nerve blocks. Clinical strategies to minimize patient movement during eye surgery are essential. Historically, eye surgeons favored general anesthesia GA , which usually provided akinesia through neuromuscular blockade and low intraocular pressure.
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Anesthesia for eye surgery
Local and Regional Anesthesia for Ophthalmic Surgery - NYSORA
The efficacy of different techniques of facial nerve block for cataract surgery was investigated. Forty four patients underwent either modified O'Brien, Atkinson, van Lint, or lid blocks. Intentional muscle activity of the orbicularis oculi muscle was recorded and the area under the EMG curve calculated for quantitative comparison of muscle activity between the groups before and after injection of lignocaine with the vasoconstrictor naphazoline nitrate. In addition, the force of lid closure was measured and lid motility determined on a subjective score scale.
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Techniques of facial nerve block.
Ocular surgery may be performed under topical , local or general anesthesia. Local anaesthesia is more preferred because it is economical, easy to perform and the risk involved is less. Local anaesthesia has a rapid onset of action and provides a dilated pupil with low intraocular pressure.
Background: Retrobulbar anesthesia RETRO , combined with a facial block, is the most frequently employed method of anesthesia in cataract surgery. There is, however, an increasing tendency to use peribulbar anesthesia PERI , which is claimed to provide the same degree of anesthesia and akinesia as RETRO while reducing many of the complications. Objectives of the study: Survey of the principal techniques of RETRO, facial block and PERI as well as of the most important local anesthetics and additives; quantitative investigation of resulting akinesia and sensory blockade; comparison of systemic and local complications literature review. Local anesthetics: A Short and weak action: lidocaine and prilocaine; advantages: good tissue penetration, low toxicity. Additives to local anesthetics: Adrenaline: prolongs the action of local anesthetics with short and intermediate duration of action, reduces the incidence of hemorrhages and of intraoperative vitreous bulging.
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