الفهرس 
Applied AnatomyOnly 14 pages are availabe for public view
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Abstract
M
ost patients presenting for ophthalmic surgery are elderly and have preexisting medical problems. Local anesthesia will usually be associated with the least morbidity and now preferred by most patients and doctors.
The aim of this work is to review and summarize the role of local ophthalmic anaesthesia including procedures, advantages and disadvantages with brief applied information about the basic anatomy, pharmacology, local anesthetic agents used in ophthalmic surgery and role of sedation and monitoring in surgery.
Local anaesthesia of the eye could be achieved by topical application of anesthetic DROPs or infiltration of the sensory nerves with the anaesthetic solution. The commonly inject able local anaesthetic agents include: Lidocaine, procaine, Chloroprocaine, Mepivacaine. The three most commonly used topical anesthetic agents are oxybuprocaine, prometacaine, amethocaine.
Although local anaesthetics are the foundation of regional anaesthesia, they have some disadvantages. They can produce unwanted motor weakness and autonomic dysfunction.
Excessive plasma concentration can cause serious central nervous system and cardiovascular toxicity.
For these reasons, clinicians have combined local anesthetics with other drugs, known as adjuvants.
There are several techniques of local anaesthesia. They are combination of regional infiltration field block and nerve block like retrobulbar block, peribulbar block and parabulbar block.
The choice of which technique to use will always depend on a balance between the patient wishes, the operative needs of the surgeon, the skills of anaesthesiologist and the place where such surgery is being performed.
Complications of local anaesthesia can be elicited from the agents used or from the block technique itself. These complications include orbital hemorrhage, globe perforation, amaurosis and optic nerve atrophy, oculocardiac reflex, extraocular muscle palsy and raising of intraocular pressure.
Sedation is often required to improve patient comfort during the placement of local eye blocks. The ideal sedative should have a rapid onset, sufficiently short duration of action to facilitate patient cooperation during surgery.
Monitoring should start before the administration of local anaesthesia and continue until the surgical procedure is completed.