الفهرس 
Anatomical Considerations for Regional Ophthalmic AnesthesiaOnly 14 pages are availabe for public view
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Abstract
M
ost ophthalmic surgeries can now be done under local anesthesia. Squint operations and even evisceration were successfully done using regional anesthesia.
Regional anesthesia is preferred to general anesthesia because it is simple procedure, low cost, less cardiovascular and respiratory side effect and early recovery. So it is extremely suitable for terms of day case surgeries.
Deep understanding of the anatomy of the orbit and the eye and the nature of the procedure to be done is essential before choosing the type of regional anesthesia.
Pre-operative preparation of the patient is of extreme importance before administration of local anesthesia. Pre-operation preparation includes psychological preparation, assessment of the patient medical condition and premeditations. Sedation before regional anesthesia is very vital.
Different sedatives may be used but the combination of midazolam and fentanyl is the most popular. It is important to avoid heavy sedation.
Standard monitoring and resuscitation should be available throughout the procedure. Different techniques for ophthalmic regional anesthesia available. Peri-bulbar block is the most popular block for anterior segment surgeries and some posterior segment surgeries. Sub-tenon anesthesia is characterized by being safe and the ability to provide continuous anesthesia by inserting cannula in the sub-tenon space.
Topical anesthesia is considered to be the future of ophthalmic anesthesia for anterior segment surgeries especially cataract surgeries but it needs a cooperative patient and a talented surgeon.
There are a wide range of complications that is caused by regional ophthalmic anesthesia, simple complications like chemosis, sight threatening like globe perforation and life threatening like brain stem anesthesia. So the attendance of the anesthetist is a must throughout the operation.
Finally it is important to emphasize that regional anesthesia is more convenient for most of ophthalmic surgeries as long as the patient profile has no contra indications.