Exam II: Specialty Flashcards
While topical anesthesia may be sufficient for certain eye procedures, the necessity of ___ of the extraocular muscles and eye lid may necessitate further anesthesia.
motionlessness (akinesia)
Avoiding general anesthesia may be valuable in certain scenarios therefore demonstrating the value of a regional technique to accomplish ___ and ___ ___ of the eye structures.
sensory, motor blockade
Knowledge of ___, surgeon preference, and ___ is important for deciding on the approach for ophthalmic anesthesia.
surgical field requirements, risk-benefit analysis
Toleration of the placement of the block and ability to tolerate the surgery using ___anesthesia should be considered.
regional
The use of sedation may result in satisfactory anxiolysis, but ___ ___should always be available, and caution is warranted when patients are at risk for airway support.
general anesthesia
The necessity of ___ ___may be affected by manipulation of the airway in the presence of sedation, such as patients with sleep apnea.
eye akinesia
One method of ___ is the application of local anesthetics to the surface of the eye.
analgesia
For many procedures, this (application of LA to eye surface) is adequate with or without ___.
sedation
Absence of ___ ___and speed of delivery make this very popular.
[Topical]
invasive injections
An application of ___ ___ is generally adequate for short procedures.
[Topical]
2% lidocaine
The ___or compartment ____ to the eye is the target of some blockades, but depositing local anesthetics outside of the cone adjacent to the cone and around the sclera can be a less invasive and adequate source of analgesia and in sufficient volumes, produce ____.
cone, posterior, akinesia
One example is the Sub-Tenon block where a specific cannula is introduced just ____ to the sclera and allowed to track ___.
external, posteriorly
The tenon capsule is a fascial layer that encapsulates the ___and produces the ____ for the Sub-Tenon block.
sclera, “container”
__-__ml is allowed to fill the space.
[Sub-Tenon]
3-5
As opposed to entry into the posterior vault/ cone, ___blocks deposit the LA into the tissue around the eye.
peri-bulbar
This decreases the chance that it fully covers all ___ muscles; owing to the partitions created ___ around the eye.
[Peri-bulbar]
extraocular, circumferentially
Larger volumes___ may be used or additional injections into the non-anesthetized quadrant can be completed to achieve akinesia.
[Peri-bulbar]
5-8ml
These blocks are achieved by similar approach to the retrobulbar in that an___ ___ 4-5 o’clock position for right eye or 7-8 o’clock for the left eye is used to advance through the conjunctiva
[Per-bulbar]
inferior lateral
A ___ direction is used until the mid-point of the globe is reached and then injection is given.
[Peri-bulbar]
caudal
This approach decreases the chance of ___ and ___compartment trauma, but increases the chance of failed akinesia on first injection.
[Peri-bulbar]
globe, posterior
A combination of ___ ___ and ___ ___ injections may produce desirable affect.
[Peri-bulbar]
superior lateral, inferior lateral
The retrobulbar block and several similar injection techniques, are accomplished through the injection of LA into the compartment directly ___ to the globe of the eye (muscle cone/ retrobulbar space).
posterior
Concurrent blockade of cranial nerves ___, ___, ___, ____, ___ accomplish the desired sensory and motor effects as the LA diffuses into the compartment nerves.
III, IV, V, VI, VII
The procedure is accomplished by injection of LA ___of ___% preservative free lidocaine after topical skin cleansing.
[Retrobulbar]
2-4ml , 1-2
