Podcast
Questions and Answers
What percentage of cataract operations use local anaesthesia?
What percentage of cataract operations use local anaesthesia?
What is the main reason for choosing general anaesthesia in ocular surgery?
What is the main reason for choosing general anaesthesia in ocular surgery?
Which of the following anaesthetics is no longer used?
Which of the following anaesthetics is no longer used?
What is the purpose of the spring used in the sub-Tenon's technique?
What is the purpose of the spring used in the sub-Tenon's technique?
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What sensation may the patient experience during the sub-Tenon's technique?
What sensation may the patient experience during the sub-Tenon's technique?
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What is a major reason for using proxymetacaine in highly anxious patients and children?
What is a major reason for using proxymetacaine in highly anxious patients and children?
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Which local anesthetic is mentioned as producing more profound anesthesia?
Which local anesthetic is mentioned as producing more profound anesthesia?
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What would be a contraindication for the use of local anesthetics in intraocular surgery?
What would be a contraindication for the use of local anesthetics in intraocular surgery?
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Why should repeated administration of tetracaine eyedrops be avoided?
Why should repeated administration of tetracaine eyedrops be avoided?
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What are potential complications of peribulbar and retrobulbar injections if not correctly administered?
What are potential complications of peribulbar and retrobulbar injections if not correctly administered?
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Study Notes
Systemic Side-Effects of Anaesthesia
- Confusion, respiratory depression, convulsions, hypotension, and bradycardia are rare systemic side-effects of anaesthesia
Choice of Anaesthetic in Ocular Surgery
- Depends on the procedure, patient, and surgeon's preference
- Local anaesthesia (LA) is used in 95% of cataract operations
- General anaesthesia (GA) is generally used for children and younger cataract patients, trauma cases, and patients who have trouble keeping still
General Anaesthesia
- Desflurane, isoflurane, nitrous oxide, and sevoflurane are commonly used
- Halothane has been discontinued
Injected Local Anaesthetic
- Used for oculoplastic procedures
- Administered through the lower lid and under the globe (peribulbar/retrobulbar anaesthesia)
- May be associated with serious complications, such as retrobulbar haemorrhage, optic nerve damage, muscle palsy, and cranial nerve damage
Sub-Tenon's Technique
- Involves an anaesthetic drop, a small spring to hold the lids open, a small incision in the conjunctiva, and infiltration of the agent
- Patients may feel a burning or stinging sensation
Ophthalmic Anaesthetics
- Act locally to block pain signals at the nerve endings in the eyes
- Available as eye drops, ointments, and gels
- Used to numb the eyes before surgery or for certain tests and procedures
- Used for measurement of intraocular pressure using applanation tonometry and in ocular surgery
Drops
- Lidocaine hydrochloride, oxybuprocaine hydrochloride, proxymetacaine hydrochloride, and tetracaine hydrochloride are commonly used
- Used for initial assessment for minor trauma, removal of conjunctivitis, and corneal foreign bodies
- Contraindicated in patients with hypersensitivity
- Administration involves a brief stinging sensation on application
- Tetracaine produces a more profound anaesthesia, but repeated administration should be avoided due to its effects on corneal epithelial cell healing
Injected Anaesthetics
- Lidocaine hydrochloride, bupivacaine, and cocaine are commonly used
- Used for minor operations, oculoplastic surgery, anterior segment, and cataract surgery
- Contraindicated in patients with refusal or concurrent medical conditions preventing correct positioning
- Administration involves subconjunctival, peribulbar, and retrobulbar injections
- Ocular side-effects are rare if correctly administered
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Description
Ophthalmic anesthetics are used to numb the eyes before surgery or for certain tests and procedures. They are available as eye drops, ointments, and gels. Learn about the different types of ophthalmic anesthetics and their uses.
