الفهرس 
Anesthetic Ophthalmic Anatomical ConsiderationsOnly 14 pages are availabe for public view
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Abstract
During the last thirty years, the practice of eye surgery has expanded and ophthalmic anesthesia has gone hand in hand to cope with that expansion of the field of eye surgery.
In this essay we discussed a detailed knowledge of the anatomy of the eye and orbit and its contents.
Basic knowledge of the anatomy of the orbit and its contents is necessary for the successful performance of anesthesia for ophthalmic surgery
Patients who present for eye surgery are frequently at the extreme ends of age. Both neonatal and geriatric anesthesia present special problems.
Preoperative patient preparation includes the psychological preparation, the preoperative assessment, review of preoperative tests, optimization of medical conditions, adequate preoperative fasting, appropriate premedication, and the explanation of anesthetic risk to patients.
In the past, general anesthesia was the most common method of anesthesia in eye surgery; regional anesthesia has begun to take the upper hand since the beginning of the twentieth century as a result of increased day-case surgery and out patient surgery with the evolution of many different methods of local anesthesia.
With general anesthesia the risks of retrobulbar or peribulbar hemorrhage, globe perforation, myotoxicity, central spread of local anesthetic with possible brain stem anesthesia, and inadequate intraoperative analgesia are virtually eliminated. Nonetheless, general anesthesia may be associated with a greater likelihood of airway complications and postoperative nausea and vomiting.
Although regional and topical anesthetic techniques have gained popularity in recent years, general anesthesia maintains in the care of certain ophthalmic patients.
A full detailed discussion is given of the local anesthetics and their adjuvant, ophthalmic medications, and anesthetic drugs.
Regional ophthalmic anesthesia has advantages of that it may be performed as a day-case, gives good akinesia, nausea and vomiting usually less, postoperative analgesia, and cheaper than general anesthesia.
Intraconal and extraconal blocks using needles are commonly used. The techniques are generally safe but although rare, serious sight- and life-threatening complications have occurred following the inappropriate placement of needles. Sub-Tenon’s block was introduced as a safe alternative to needle techniques but complications have arisen following this block as well. Currently, there is no absolutely safe ophthalmic regional block. It is essential that those who are involved in the care of these patients have a thorough knowledge of the techniques used.
Regional anesthesia for eye surgery usually consists of a regional block, a facial nerve block, and intravenous sedation. Many techniques are used nowadays for local ophthalmic anesthesia namely, peribulbar, retrobulbar, prolonged peribulbar anesthesia with indwelling catheter, sub-conjunctival, sub-Tenon’s and topical corneo-conjunctival blocks, topical plus intra ocular anesthesia, deep topical anesthesia, local anesthesia for lacrimal surgery, isolated nerve block such as supratrochlear nerve, Supraorbital nerve, frontal nerve, lacrimal nerve, nasociliary nerve, infraorbital nerve, and percuteneous anesthesia