Huerta-López A

Language: Spanish
References: 14
Page: 46-51
PDF size: 254.47 Kb.

ABSTRACT

Perioperative morbidity and mortality in ophthalmic surgery is low, considering that most of the population that requires these procedures are elderly patients with multiple comorbidities. Embryologically, the optic nerve and the meningeal sheaths that cover it originate from the ectoderm, are closely related to the meningeal layers that cover the central nervous system, whereby their inadvertent puncture during orbital blocks causes drug spread by the cerebrospinal fluid through the subarachnoid space to the brainstem. The case of a 61-year-old female patient is reported, programmed for lavage of the left eye vitreous chamber. The anesthetic technique was sedation and retrobulbar block; after this procedure, neurological impairment, cardiovascular alterations, decreased oxygen saturation were observed, maintaining spontaneous ventilation but with airway obstruction; ventilatory support is given and antihypertensive is administered, responding favorably 40 minutes after retrobulbar block. The relationship between an orbital block and the appearance of neurological, cardiovascular or respiratory symptoms should raise suspicion of brainstem anesthesia. The most important thing is early recognition and attention to this complication, to avoid neurological and cardiovascular sequelae or even death.

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