Ocular Anaesthetic Failure Following Peribulbar Administration of Lidocaine
This article reports a failure in achieving adequate anaesthesia following local peri-ocular block. Failure can be partial where subtle pain is felt and it can be total, in which akinesia and analgesia are not achieved. We report a case of failed local(ocular) anaesthesia in a Nigerian male scheduled for intra ocular lens implantation.
Our patient is a 48-year-old man who presented to the eye clinic with complaints of poor vision of count finger in left eye following cataract surgery at an external eye facility. Examination revealed mid-peripheral cornea opacity and aphakia. Posterior segment examination was essentially normal. A +10 lens over the index eye improved visual acuity to 6/12. He was scheduled for elective scleral fixation of posterior chamber intraocular lens, which was aborted intraoperatively due to failure to achieve adequate ocular anaesthesia probably due to local drug resistance.
More research into the causes of anaesthetic failure is required and it is worth noting that anaesthetic failure should be approached using an alternative anaesthetic agent or alternative route.