An elderly lady with COPD has chronic SOB. She is listed for cataract extraction. What is the anaesthetic of choice?
a. Facial nerve block
b. Bupivacaine infiltration of the peri-orbital skin
c. IV midazolam
d. Peribulbar acupuncture
e. Peribulbar lignocaine infiltration
f. Topical xylocaine
g. IV alfentanil
h. Epidural anesthesia
i. General anesthesia
j. Retrobulbar xylocaine Inj
answer: F
In the last few years the shift in anaesthesia in ophthalmic surgery has
been towards topical anaesthesia. Cataract surgeries have now become
sutureless with the advent of phacoemulsification and rapid visual
rehabilitation is expected. Topical agents like 0.5 % proparacaine are
used to anaesthetise the nerves. All the complications associated with
orbital injections can be avoided. It is the ideal choice for same day
surgery, where patients can be immediately discharged post operatively.
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