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  • Title: Simulated peribulbar injection of anesthetic.
    Author: Zahl K, Nassif JM, Meltzer MA, Som P.
    Journal: Ann Ophthalmol; 1991 Mar; 23(3):114-7. PubMed ID: 2039175.
    Abstract:
    To evaluate whether intracranial spreading of a local anesthetic might occur after a peribulbar injection, we did simulated peribulbar anesthetic injections with radiopaque dye into two cadaver heads. Using a standard and modified peribulbar injection with a 25-gauge needle, the four orbits were injected with 8 mL of dye. Computed tomography revealed that the dye spread intraconally and intracranially. In one case the dye was seen tracking along the optic nerve sheath. Since intracranial spreading of a local anesthetic may be associated with adverse sequelae (i.e., brainstem anesthesia), we urge caution and vigilance after both peribulbar and retrobulbar anesthetic injections to prevent cardiopulmonary compromise.
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