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Br J Ophthalmol 2001;85:796-798 doi:10.1136/bjo.85.7.796
  • Scientific correspondence

Intraocular pressure and pulsatile ocular blood flow after retrobulbar and peribulbar anaesthesia

  1. Russell Watkinsa,b,
  2. Bijan Beigia,
  3. Mark Yatesa,
  4. Bernard Changc,
  5. Evangelos Linardosa
  1. aDepartment of Ophthalmology, Norfolk and Norwich University Hospital NHS Trust, West Norwich Hospital, Bowthorpe Road, Norwich NR2 3TU, UK, bDepartment of Optometry, Anglia Polytechnic University, East Road, Cambridge CB1 1PT, UK, cDepartment of Ophthalmology, Leeds General Infirmary, Clarendon Wing, Belmont Grove, Leeds LS2 9NS, UK
  1. Dr Russell Watkins, Department of Optometry, Anglia Polytechnic University, East Road, Cambridge CB1 1PT, UKr.j.watkins{at}apu.ac.uk
  • Accepted 14 February 2001

Abstract

AIMS This study investigated the effect of peribulbar and retrobulbar local anaesthesia on intraocular pressure (IOP) and pulsatile ocular blood flow (POBF), as such anaesthetic techniques may adversely affect these parameters.

METHODS 20 eyes of 20 patients who were to undergo phacoemulsification cataract surgery were prospectively randomised to receive peribulbar or retrobulbar anaesthesia. The OBF tonometer (OBF Labs, Wiltshire, UK) was used to simultaneously measure IOP and POBF before anaesthesia and 1 minute and 10 minutes after anaesthesia. Between group comparisons of age, baseline IOP, and baseline POBF were performed using the non-parametric Mann-Whitney test. Within group comparisons of IOP and POBF measured preanaesthesia and post-anaesthesia were performed using the non-parametric Wilcoxon signed ranks test for both groups.

RESULTS There was no statistically significant IOP increase post-anaesthesia in either group. In the group receiving peribulbar anaesthesia, there was a significant reduction in POBF initially post-anaesthesia which recovered after 10 minutes. In the group receiving retrobulbar anaesthesia, there was a persistent statistically significant reduction in POBF.

CONCLUSIONS Retrobulbar and peribulbar injections have little effect on IOP. Ocular compression is not needed for IOP reduction when using local anaesthesia for cataract surgery. Conversely, POBF falls, at least for a short time, when anaesthesia for ophthalmic surgery is administered via a retrobulbar route or a peribulbar route. This reduction may be mediated by pharmacologically altered orbital vascular tone. It may be safer to use other anaesthetic techniques in patients with ocular vascular compromise.

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