Description

Regional ocular anaesthesia for intraocular surgery is increasing in popularity and is frequently administered by anaesthetists. General anaesthesia is usually reserved for selected patients with specific indications. There are numerous techniques available and the choice of block is usually dictated by the anaesthetists experience and personal preference. Retrobulbar anaesthesia has been losing favour, as the risks associated with needle placement deep into the orbit are significant. Peribulbar anaesthesia uses a shorter needle but is also not without risks of needle related injury. Sub-Tenon’s anaesthesia has recently been developed as a “no-needle” technique. Topical anaesthesia for cataract surgery is gaining in popularity, however, there are patients where lack of cooperation will require formal block with induced ocular akinesis. Several different local anaesthetic agents are in use and there are a number of additives used which aim to improve efficacy. This review describes current techniques of regional ocular anaesthesia and discuss their advantages and disadvantages.