Skip Navigation


BJA Advance Access originally published online on October 23, 2008
British Journal of Anaesthesia 2008 101(6):855-859; doi:10.1093/bja/aen293
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
101/6/855    most recent
aen293v1
Right arrow E-Letters: Submit a response to the article
Right arrow E-letters: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in BJA
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Luyet, C.
Right arrow Articles by Greif, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Luyet, C.
Right arrow Articles by Greif, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

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

C. Luyet1, U. Eichenberger1,*, B. Moriggl3, L. Remonda2 and R. Greif1

1 Department of Anaesthesiology and Pain Therapy
2 Department of Diagnostic and Interventional Neuroradiology, Bern University Hospital and University of Bern, Inselspital, CH-3010 Bern, Switzerland
3 Department of Anatomy, Histology, and Embryology, Innsbruck Medical University, A-6020 Innsbruck, Austria

* Corresponding author. E-mail: urs.eichenberger{at}insel.ch

Background: 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: 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: 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: 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.

Keywords: anaesthetic techniques, regional; anaesthetic techniques, regional, retrobulbar; anatomy; monitoring, ultrasound


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?

Related articles in BJA:

In the December 2008 BJA...

BJA 2008 101: NP. [Extract] [Full Text]  



This article has been cited by other articles:


Home page
 Br J AnaesthHome page
S. Gayer, H. Palte, C. Kumar, C. Luyet, U. Eichenberger, C. Tappeiner, and R. Greif
Real-time visualization of ultrasound-guided retrobulbar blockade: an imaging study
Br. J. Anaesth., April 1, 2009; 102(4): 561 - 562.
[Full Text] [PDF]

E-letters:

Read all E-letters

Real-time visualization of ultrasound-guided retrobulbar blockade: an imaging study
Steven Gayer, et al.
British Journal of Anaesthesia, 5 Dec 2008 [Full text]
Real-time visualization of ultrasound-guided retrobulbar blockade: an imaging study
Cédric Luyet, et al.
British Journal of Anaesthesia, 10 Jan 2009 [Full text]
Real time visualization of ultrasound-guided retrobulbar blockade: an imaging study
Anthony P Rubin
British Journal of Anaesthesia, 17 Jan 2009 [Full text]

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.