Ortiz M, Valls R, Vallés J, Blanco D, Vidal F
Department of Anesthesia, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Reg Anesth. 1995 Jul-Aug;20(4):337-42.
Peribulbar anesthesia has fewer complications than retrobulbar anesthesia, but ocular perforation has also been described in peribulbar anesthesia. This study aims to verify by computed tomography that the recommended points for performing peribulbar anesthesia are safe.
Three human corpses were used. The puncture points were position A (superior internal orbital angle and inferior external orbital angle), position B (superior and inferior orbital median line), and position C (superior external and inferior internal orbital angle). Contrast diffusion was studied in each position at 3, 4, 5, and 10 minutes after contrast injection.
Among upper eyelid punctures, the only one anatomically safe is the internal angle puncture, given that either in the median line or the external angle there is a chance of eye globe perforation. Lower eyelid positions are a safe distance from the optic nerve and ocular globe. Contrast diffusion was satisfactory in positions A and B. There was little diffusion in position C.
The median or external superior angle eyelid puncture may cause eye globe perforation.
球周麻醉的并发症比球后麻醉少，但球周麻醉也有发生眼球穿孔的报道。本研究旨在通过计算机断层扫描验证进行球周麻醉的推荐穿刺点是否安全。
使用三具人体尸体。穿刺点分别为A点（眶内上角和眶外下角）、B点（眶上下中线）和C点（眶外上和眶内下角）。在注射造影剂后3、4、5和10分钟，研究每个位置的造影剂扩散情况。
在上眼睑穿刺中，从解剖学角度来看唯一安全的是内角穿刺，因为在中线或外角穿刺都有眼球穿孔的风险。下眼睑穿刺位置与视神经和眼球有安全距离。A点和B点的造影剂扩散情况良好。C点的扩散较少。
上眼睑中线或外角穿刺可能导致眼球穿孔。
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