VARIOUS ANESTHETIC AGENTS USED IN RETROBULBAR INJECTIONS

Abstract

RETROBULBAR anesthesia was first described by Pooley¹ in 1914, but there are still many misconceptions concerning its mode of action and there is considerable disagreement about indications for its use in surgery of the eye. Spaeth,² in his textbook on ophthalmic surgery, stated that the danger from forcible contraction of the four rectus muscles is greater than from squeezing of the orbicularis oculi muscle in intraocular surgery. He said, however, that it is not wise to use a retrobulbar anesthesia in a prominent eye. Kirby³ described a proptosis after injection of 1 cc. of procaine hydrochloride, which he said may have been due to hemorrhage or may have been the result of a transudation producing edema of the orbital tissues; he, therefore, used retrobulbar anesthesia in selected cases only but made no mention of what his criteria were. Elschnig⁴ mentioned that there resulted some loss of