专家共识

球后阻滞操作应用的专家共识

Expert consensus on the application of retrobulbar block

:595-600
 
球后阻滞是将局部麻醉药注入眼球后方的肌锥内,通过阻断鼻睫神经、动眼神经和睫状神经节,达到镇痛,限制眼球运动和降低眼内压的作用。现代球后阻滞技术是内眼手术眼球制动与麻醉的“金标准”,也是最常用的眼部区域阻滞方式。虽然与该技术相关的并发症少见,但可危害视力甚至危及生命。本专家共识介绍了球后阻滞的应用范围,系统描述了支配眼球运动与感觉的神经解剖、球后阻滞的安全性、操作方法、常用药物、禁忌证和并发症的处理等,为此技术的临床应用提供指导。
Retrobulbar block refers to the injection of local anesthetics into the muscle cone behind the eyeball, blocking the ciliary, oculomotor, and ciliary ganglion nerves, to provide pain relief, restrict eye movement, and reduce intraocular pressure. Modern retrobulbar block is the "gold standard" for eyeball immobilization and anesthesia in intraocular surgeries, and it is the one of the most commonly used methods for ocular regional block. Although the complications related to this method are rare, the complications will threaten the vision and even life. Th is expert consensus introduces the application scope of retrobulbar block, and systematically describes functional neuroanatomy of eye sensation and movements, safety and procedures of retrobulbar block, local anesthetics, contraindications and complications of the block, which can provide the reference for clinical application of this method.
病例报告

球后阻滞导致局部麻醉药中枢毒性反应1例:对侧眼球运动障碍

One case of central toxicity resulted from retrobulbar block: contralateral ocular dyskinesia

:766-768
 
球后阻滞是眼科手术中常见的麻醉方式之一,若操作不当,可造成严重并发症,包括局部麻醉药物的毒性反应等。现报告1例26岁诊断为“视网膜脱离”拟行眼底手术的女性患者,在球后阻滞10min后,患者出现心率增快、血压升高后下降、吞咽困难、声音嘶哑、呼吸困难及SpO2下降,伴随对侧眼球运动障碍,全身肌力下降等临床表现。及时给予生命支持等对症处理后,患者上述临床表现好转,并随后在全身麻醉下完成手术。
Retrobulbar block is one of the common anesthesia methods in ophthalmic surgery, however, misconducting the procedure would result in severe complications including central toxicity from local anesthetics. This study presented a 26-year-old female patient diagnosed retinal detachment for retinal surgery under retrobulbar block, 10 min after anesthesia, the patient initially exhibited increased heart rate and blood pressure, inability to swallow secretions (sputum), hoarseness, and dyspnea, then SpO2 decreased, the patient displayed contralateral eye movement disorder, reduced systemic muscle strength and other clinical manifestations. The condition was improved with the treatments for life support, and the surgery completed uneventfully under general anesthesia with tracheal intubation.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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