Real-time visualization of ultrasound-guided retrobulbar blockade: an imaging study

Luyet, C; Eichenberger, U; Moriggl, B; Remonda, L; Greif, R (2008). Real-time visualization of ultrasound-guided retrobulbar blockade: an imaging study. British journal of anaesthesia, 101(6), pp. 855-859. Oxford: Oxford University Press 10.1093/bja/aen293

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BACKGROUND: /st> Retrobulbar anaesthesia allows eye surgery in awake patients. Severe complications of the blind techniques are reported. Ultrasound-guided needle introduction and direct visualization of the spread of local anaesthetic may improve quality and safety of retrobulbar anaesthesia. Therefore, we developed a new ultrasound-guided technique using human cadavers. METHODS: /st> In total, 20 blocks on both sides in 10 embalmed human cadavers were performed. Using a small curved array transducer and a long-axis approach, a 22 G short bevel needle was introduced under ultrasound guidance lateral and caudal of the eyeball until the needle tip was seen 2 mm away from the optic nerve. At this point, 2 ml of contrast dye as a substitute for local anaesthetic was injected. Immediately after the injection, the spread of the contrast dye was documented by means of CT scans performed in each cadaver. RESULTS: /st> The CT scans showed the distribution of the contrast dye in the muscle cone and behind the posterior sclera in all but one case. No contrast dye was found inside the optic nerve or inside the eyeball. In one case, there could be an additional trace of contrast dye behind the orbita. CONCLUSIONS: /st> Our new ultrasound-guided technique has the potential to improve safety and efficacy of the procedure by direct visualization of the needle placement and the distribution of the injected fluid. Furthermore, the precise injection near the optic nerve could lead to a reduction of the amount of the local anaesthetic needed with fewer related complications.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Luyet, Cédric; Eichenberger, Urs and Greif, Robert

ISSN:

0007-0912

ISBN:

18948389

Publisher:

Oxford University Press

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 15:01

Last Modified:

27 Apr 2018 08:55

Publisher DOI:

10.1093/bja/aen293

PubMed ID:

18948389

Web of Science ID:

000260971500016

BORIS DOI:

10.7892/boris.26677

URI:

https://boris.unibe.ch/id/eprint/26677 (FactScience: 81126)

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