LOCAL ANESTHESIA IN OPHTHALMOLOGY

With local anesthesia for intraocular operations, postoperative agitation, nausea and vomiting are less frequent, which tends to reduce the number of intraocular complications. Bleeding is less troublesome, and secretions are better controlled. Fewer cardiac and pulmonary complications occur with local anesthesia.Meperidine hydrochloride (Demerol®) and pentobarbital sodium (nembutal) remain drugs of choice in preoperative medication. Lidocaine (Xylocaine®), 1 or 2 per cent, is a most satisfactory local anesthetic for intraocular operations.Complete akinesia of the eyelids has been achieved in every instance by a modified combination of the O''Brien and Van Lint techniques, using lidocaine 1 per cent.Nasolacrimal procedures can be performed satisfactorily by injecting the nasociliary and infraorbital nerves with lidocaine 2 per cent.     

GENERAL ANESTHESIA IN OPHTHALMOLOGY

General or a combination of local and general anesthesia is beneficial in ophthalmic operations. With foreknowledge that they are to be asleep, patients approach operation with less trepidation, and during the procedure the surgeon can be more relaxed.In a series of 300 cases reviewed, no complications that could be attributed to general anesthesia occurred at the operative site. Nasopharyngeal and tracheal irritation sometimes developed.Anesthesia should be conducted by a well-trained, alert anesthetist; and the method and the agent should be determined after thorough examination and appraisal of the patient and consideration of the nature of the operation to be done.