Local experience with caruncular single injection peribulbar anesthesia

Introduction: Peribulbar anesthesia is currently considered the regional anesthetic technique of choice for various ophthalmic surgical procedures because of its effectiveness and low incidence of complications. Recent techniques have reduced the number of injections from two to one and are undergoing evaluation. Objectives: To measure the efficacy and safety of the caruncular single injection peribulbar technique for various surgical procedures performed at an ophthalmic clinic in Popayan city, Colombia. Methods: Patients undergoing various ophthalmic procedures were included. The anesthetic technique used was based on a caruncular single peribulbar injection. The anesthetic agent used contained 0.5% bupivacaine 2.5 ml, 2% lidocaine 2.5 ml with hyaluronidase 7 IU/ml. Patients were evaluated at 10, 15, and 20 min. The motor functionality of the four extra ocular muscles and the upper and lower eyelid motor control was measured. Results: 137 patients were included; 54% were females and 77% ASA II. 10 minutes into the evaluation, 92% of the patients achieved an adequate level of anesthesia to proceed with surgery. 36 patients (26.3%) required a booster dose of an additional peribulbar injection. Twenty-two patients (16%) reported mild pain during the anesthetic procedure. There were four cases of chemosis (3%). Conclusions: Using the caruncular single peribulbar injection, most patients achieved an appropriate ocular block for multiple ophthalmic surgical procedures. As time elapses, this block becomes stronger and the incidence of complications is low.

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