Peribulbar and retrobulbar block techniques in ocular evisceration

Abstract

Ocular evisceration is a surgical procedure that is aimed at removing completely the content of the eyeball (cornea, iris and retina) keeping the sclera and the extrinsic muscles of the eye. This is an infrequent procedure that is performed with local-regional anesthesia. We present the case of a surgical intervention in a 54-year-old male patient who was treated at the ophthalmology emergency room of the Clinico-Surgical Teaching Hospital of Manzanillo, Granma, and was decided to perform evisceration of the left eye, due to a trauma at orbital level. He had a history of persistent moderate bronchial asthma, with a last crisis five days before, who stated to have long-term steroidal inhalators. The surgical procedure was decided to be performed with retrobulbar and peribulbar block. Lidocaine at 2 % and isobaric bupivacaine at 0,5 % were used, in equal proportions, 4 mL for each block. With this anesthetic method the need to approach the airway was avoided, the risk of bronchoaspiration was minimized and postoperative analgesic was guaranteed. Transoperative care went without complications, with minimum hematic losses. The patient was hemodynamically stable, with spontaneous respiration. A surgical time of 50 minutes was reported. At the end of surgery the patient was sent to the postoperative ward where he was constantly monitored, with multimodal analgesic using 150 mg of diclofenac sodium in 250 mL of physiological serum, through intravenous infusion of 7 drops per minute. No postoperative complications were reported.