Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11646
Peer-review started: July 27, 2022
First decision: August 22, 2022
Revised: September 5, 2022
Accepted: September 29, 2022
Article in press: September 29, 2022
Published online: November 6, 2022
Apnea caused by retrobulbar anesthesia is a very rare but severe complication during ophthalmic surgery.
We report a rare case of apnea caused by retrobulbar anesthesia, and emergency resuscitation was used. A 74-year-old female patient was diagnosed with rhegmatogenous retinal detachment in the right eye and planned to undergo vitrectomy under retrobulbar anesthesia. After the retrobulbar anesthesia in her right eye, she became unconscious and apneic. It was suggested that she had developed brainstem anesthesia. Assisted ventilation was initiated. Atropine 0.5 mg, epinephrine 1 mg, ephedrine 30 mg, and lipid emulsion were given. Five minutes later, her consciousness and breathing gradually returned, but with uncertain light perception in her right eye. Alprostadil 20 µg was given, and after 2 h her visual acuity resumed to the preoperative level.
Brainstem anesthesia is a serious complication secondary to retrobulbar anesthesia. Medical staff should pay attention to the identification of brainstem anesthesia and be familiar with the emergency treatment for this complication.
Core Tip: Apnea caused by retrobulbar anesthesia is a very rare but severe complication. Failure to recognize brainstem anesthesia or delaying the treatment may be life threatening. We report a rare case of apnea caused by retrobulbar anesthesia, and emergency resuscitation was used. Assisted ventilation and vasodilator treatment were used, and the consciousness and breathing of the patient was gradually recovered. The mechanism of retrobulbar anesthesia is varied, but a skillful operation of retrobulbar anesthesia is important. Doctors and nurses should be aware of the potential risk of retrobulbar anesthesia, and be familiar with the resuscitation procedures.