Case Reports
Generalized seizure after peribulbar anesthesia
Case Report Details
First Author: C.Benmlih MOROCCO
Co Author(s): C. Khodriss A. Bennis F. Chraibi M. Abdellaoui I. Benatiya Andaloussi
Abstract Details
Purpose:
Several anesthesic techniques are adopted in cataract surgery.
Although the effectiveness and the safety of peribulbar anesthesia has been prouved, many complications have been reported. Of these, convulsion is a rare but fatal complication.
The purpose of this case report is to raise awareness about the necessity of respect of safety standards in anesthesia: technical and human resources should be available for emergency cases.
Setting:
Ophthalmology department, Hassan II University Hospital, Sidi Mohamed benabdellah University,Fez, Morocco.
Report of Case:
A 61 year-old africain woman was admitted for cataract surgery and lens implant for her right eye. Her medical history includes hypertension for nine years; she was operated on for a cataract in her left eye under locoregional anesthesia 8 months ago. Peribulbar anesthesia was realized with two injections in the lower temporal peribulbar space. Eight minutes after, the patient had generalized tonic-clonic seizures, the blood pressure increased to 190/110 and arterial oxygen saturation decreased to 80%. She was placed in a half-sitting position with a face mask delivering 100% oxygen, Midazolam 1mg was administrated intravenously by the anaesthesiologist which controlled the seizures immediately. The postictal state lasts 15 minutes, saturation increased to 100% and blood pressure decreased to 140/85. The neurological examination noted no deficit. She underwent cataract surgery 2 months later under general anesthesia.
Conclusion/Take Home Message:
Needle test aspiration before injection, close monitoring, the presence of anaesthesiologist during the entire procedure, a usable operating room where cataract surgery is performed are all necessary to prevent and deal with complications after locoregional anesthesia.
Financial Disclosure:
None
