Brainstem Anesthesia Following Retrobulbar Block For Globe Rupture Repair

Proposal Number:

MCC-7118 

Proposal Type:

Medically Challenging Case Report Poster 

Author:

Tavish Nanda  
NYC Health + Hospitals/Harlem

Co-Author(s):

Lisa Ross  
NYC Health + Hospitals/Harlem
Gregory Kerr  
NYC Health + Hospitals/Harlem

Abstract:

Retrobulbar blocks can be associated with several potential complications (1-3%) including hemorrhage, ocular perforation, retinal vascular occlusion, seizure and cardiorespiratory distress. In rare cases, subarachnoid or intradural injection can also lead to brainstem anesthesia due to anesthetic spread from CNII to CNVIII. Symptoms of this complication include loss of consciousness, hypotension, respiratory depression, and contralateral ophthalmoplegia. We present an unusual case of brainstem anesthesia from a retrobulbar block placed for post-operative pain relief following ruptured globe repair. The incident wasn't immediately recognized, as the patient was under general anesthesia, but led to apnea around the time of extubation.

Professional Category:

Resident/Trainee

Keywords:

Regional
Other - Ophthalmology

Supporting Image: retrobulbar3.jpg
   ·Retrobulbar Block
Supporting Image: retrobulbarspread.tif
   ·Retrobulbar Block Spread
 

Enter up to two references.

  Reference
1. Gunja N, Varshney K. Brainstem anaesthesia after retrobulbar block: A rare cause of coma presenting to the emergency department. Emergency Medicine Australia. 3 February 2006. https://doi.org/10.1111/j.1742-6723.2006.00806.x
2. Palte HD, Hoa DP, Canseco AP. Surdity in the OR: An Unusual Case of Brainstem Anesthesia. Case Reports in Anesthesiology. Volume 2017 (2017), Article ID 4645381. https://dol.org/10.1155/2017/4645381