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Case Reports
Cardiopulmonary arrest after retrobulbar anesthesia in a patient with an orbital roof defect.
- D T Weidenthal and J W King.
- Division of Ophthalmology, Saint Luke's Medical Center, Cleveland, OH 44104, USA.
- Am. J. Ophthalmol. 1995 Oct 1;120(4):535-6.
PurposeCardiopulmonary arrest developed after injection of bupivacaine hydrochloride, lidocaine, and hyaluronidase in a 78-year-old woman who had previously undergone ipsilateral transcranial orbital surgery with removal of the bone of the orbital roof.MethodsThe patient required immediate cardiopulmonary resuscitation and intubation. Mechanical ventilation was necessary for 18 hours before spontaneous respirations resumed.ResultsThe patient improved and was discharged on the fifth postanesthetic day.ConclusionsThere were several possible mechanisms by which the local anesthetic could have entered the central nervous system. In patients with orbital roof defects, we recommend that retrobulbar anesthetic agents be used with caution.
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