![]() It is important to understand the anatomic considerations of the orbit as it pertains to completing nerve blocks for regional anesthesia and achieving an akinetic globe. According to the anesthesia closed claims project, eye injury occurred in 3% of all claims in the database, further indicating the importance of protecting and caring for the eyes during anesthesia, especially in mitigating the risk associated with peripheral nerve blocks. Management of perioperative complications will be discussed as the adverse events can result in significant life-threatening harm and permanent visual impairments for patients presenting for ophthalmic surgeries. The anatomy and physiology will be reviewed as well to provide a complete understanding of the structures of the eye and the important hemodynamic manifestations of the oculocardiac reflex. This article aims to understand the anesthetic considerations and implications along with the general and regional anesthetic techniques, including topical, retrobulbar, peribulbar, and sub-Tenon blocks, that can be used to provide anesthesia. ![]() The important anesthetic consideration for this surgery would concern the need for general versus local anesthesia and the necessary avoidance of nitrous oxide with intraoperative use of sulfur hexafluoride (SF6). Another commonly performed ophthalmic surgery is vitreoretinal. Moreover, glaucoma affects nearly 67 million people in the united states, and understanding the concept of intraocular pressure concerning intravenous and volatile anesthetics becomes increasingly important to providing anesthetic care, especially in patients with comorbidities. ![]() It is estimated that nearly 26 million Americans are suffering from cataracts, and approximately 3.6 million cataract extractions are completed annually, making it the most commonly performed surgical procedure in the united states. ![]() The most common eye surgeries performed today are cataracts, glaucoma, and vitreoretinal surgery. It is paramount to minimize risks that may present during eye surgery under anesthesia and sedation while anticipating and managing any potential outcomes associated with eye surgeries. The goals of anesthesia during elective eye surgery should focus on patient safety and providing analgesia to elicit a pain-free experience and create optimal surgical conditions to facilitate the procedure in collaboration with the perioperative staff, including the ophthalmologic surgeons and surgical technicians. Understanding the anesthetic implications and approaches to ophthalmic surgery is very important for providing anesthetic care in the perioperative period. Outline the anesthetic techniques used by the interprofessional team and indications for providing regional anesthesia for patients undergoing eye surgery.Describe complications that may result from regional anesthesia for eye blocks.Explain the oculocardiac reflex and review the hemodynamic changes that can result.Review the anatomy of the orbit and describe changes in intraocular pressure that result from intravenous and volatile agents.This activity is intended to guide the multidisciplinary and interprofessional operative team consisting of nurses, surgical technicians, and specialty physicians in working together to provide a safe and uneventful perioperative experience. Understanding the basic principles of intravenous and volatile anesthetics concerning intraocular pressure and preparing for potential complications is essential to providing excellent patient care. This article will highlight major anesthetic topics related to common eye procedures and will include a brief discussion regarding the various anesthetic approaches and intraoperative management of common eye surgeries. This activity reviews the anesthetic implications associated with patients undergoing eye surgeries.
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