Abstract
Objective: To compare injectate distribution and potential complications of retrobulbar and peribulbar injections in cat cadavers. Study design: Prospective randomized masked study. Animals: Ten cat cadavers (20 eyes). Methods: A dorsomedial retrobulbar injection (RB) of 1 mL of 0.5% bupivacaine and iopamidol (1:1) was performed in seven eyes. A dorsomedial peribulbar injection (PB-1) of 4 mL of the same injectate was performed in seven eyes, and two peribulbar injections (PB-2) of the same injectate, divided equally between the dorsomedial and ventrolateral regions (2 mL each) were performed in six eyes. Intraocular pressure (IOP) was measured before, immediately and 15 minutes after injection. Cadavers underwent computed tomography before and following injections. A radiologist scored injectate distribution within the intraconal space (none, moderate, or large) and around the optic nerve (degrees). An injection was defined as likely to provide adequate regional anesthesia if the volume of distribution of intraconal injectate was 'large' and it contacted over 270° of the optic nerve circumference. Results: The success rate (95% confidence interval) of RB, PB-1, and PB-2 injections was 71% (29.0-96.3%), 86% (42.1-99.6%), and 67% (22.3-95.7%), respectively. With all three techniques, IOP increased significantly after injection, but returned to baseline by 15 minutes following RB injection. No intraocular, intravascular, intrathecal, or intraneural injectate was observed. Conclusion and clinical relevance: The single-peribulbar injection technique may be superior to retrobulbar or double-peribulbar injections, however, all techniques require further studies in live cats to determine safety and efficacy prior to clinical use.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 623-631 |
| Number of pages | 9 |
| Journal | Veterinary Anaesthesia and Analgesia |
| Volume | 40 |
| Issue number | 6 |
| DOIs | |
| State | Published - Nov 2013 |
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Keywords
- Cats
- Intraocular pressure
- Peribulbar anesthesia
- Regional anesthesia
- Retrobulbar anesthesia
ASJC Scopus subject areas
- veterinary(all)
- Medicine(all)
Cite this
Retrobulbar and peribulbar regional techniques in cats : A preliminary study in cadavers. / Shilo-Benjamini, Yael; Pascoe, Peter J; Maggs, David J; Kass, Philip H; Wisner, Erik R.
In: Veterinary Anaesthesia and Analgesia, Vol. 40, No. 6, 11.2013, p. 623-631.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Retrobulbar and peribulbar regional techniques in cats
T2 - A preliminary study in cadavers
AU - Shilo-Benjamini, Yael
AU - Pascoe, Peter J
AU - Maggs, David J
AU - Kass, Philip H
AU - Wisner, Erik R
PY - 2013/11
Y1 - 2013/11
N2 - Objective: To compare injectate distribution and potential complications of retrobulbar and peribulbar injections in cat cadavers. Study design: Prospective randomized masked study. Animals: Ten cat cadavers (20 eyes). Methods: A dorsomedial retrobulbar injection (RB) of 1 mL of 0.5% bupivacaine and iopamidol (1:1) was performed in seven eyes. A dorsomedial peribulbar injection (PB-1) of 4 mL of the same injectate was performed in seven eyes, and two peribulbar injections (PB-2) of the same injectate, divided equally between the dorsomedial and ventrolateral regions (2 mL each) were performed in six eyes. Intraocular pressure (IOP) was measured before, immediately and 15 minutes after injection. Cadavers underwent computed tomography before and following injections. A radiologist scored injectate distribution within the intraconal space (none, moderate, or large) and around the optic nerve (degrees). An injection was defined as likely to provide adequate regional anesthesia if the volume of distribution of intraconal injectate was 'large' and it contacted over 270° of the optic nerve circumference. Results: The success rate (95% confidence interval) of RB, PB-1, and PB-2 injections was 71% (29.0-96.3%), 86% (42.1-99.6%), and 67% (22.3-95.7%), respectively. With all three techniques, IOP increased significantly after injection, but returned to baseline by 15 minutes following RB injection. No intraocular, intravascular, intrathecal, or intraneural injectate was observed. Conclusion and clinical relevance: The single-peribulbar injection technique may be superior to retrobulbar or double-peribulbar injections, however, all techniques require further studies in live cats to determine safety and efficacy prior to clinical use.
AB - Objective: To compare injectate distribution and potential complications of retrobulbar and peribulbar injections in cat cadavers. Study design: Prospective randomized masked study. Animals: Ten cat cadavers (20 eyes). Methods: A dorsomedial retrobulbar injection (RB) of 1 mL of 0.5% bupivacaine and iopamidol (1:1) was performed in seven eyes. A dorsomedial peribulbar injection (PB-1) of 4 mL of the same injectate was performed in seven eyes, and two peribulbar injections (PB-2) of the same injectate, divided equally between the dorsomedial and ventrolateral regions (2 mL each) were performed in six eyes. Intraocular pressure (IOP) was measured before, immediately and 15 minutes after injection. Cadavers underwent computed tomography before and following injections. A radiologist scored injectate distribution within the intraconal space (none, moderate, or large) and around the optic nerve (degrees). An injection was defined as likely to provide adequate regional anesthesia if the volume of distribution of intraconal injectate was 'large' and it contacted over 270° of the optic nerve circumference. Results: The success rate (95% confidence interval) of RB, PB-1, and PB-2 injections was 71% (29.0-96.3%), 86% (42.1-99.6%), and 67% (22.3-95.7%), respectively. With all three techniques, IOP increased significantly after injection, but returned to baseline by 15 minutes following RB injection. No intraocular, intravascular, intrathecal, or intraneural injectate was observed. Conclusion and clinical relevance: The single-peribulbar injection technique may be superior to retrobulbar or double-peribulbar injections, however, all techniques require further studies in live cats to determine safety and efficacy prior to clinical use.
KW - Cats
KW - Intraocular pressure
KW - Peribulbar anesthesia
KW - Regional anesthesia
KW - Retrobulbar anesthesia
UR - http://www.scopus.com/inward/record.url?scp=84885869092&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885869092&partnerID=8YFLogxK
U2 - 10.1111/vaa.12060
DO - 10.1111/vaa.12060
M3 - Article
C2 - 23782789
AN - SCOPUS:84885869092
VL - 40
SP - 623
EP - 631
JO - Veterinary Anaesthesia and Analgesia
JF - Veterinary Anaesthesia and Analgesia
SN - 1467-2987
IS - 6
ER -