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In this 249th episode I welcome Dr. Gillian Isaac back to the show for another ABA Keyword episode. We discuss retrobulbar blocks and the oculocardiac reflex.
CME: Link
References: Barash Clinical Anesthesia 8th edition, OpenAnesthesia.com, and Anesthesiahub.com
Random Recs:
Incorrectly states trochlear nerve has no involvement with the eye. While extraconal (and the correct question answer) it innervates the superior oblique eye muscle and not the ear.
Also, when Gillian lists contraindications to Retrobulbar block, glaucoma is not listed. Some of these patients get Peribulbar blocks for trabeculectomies which cause more chemosis than Retrobulbar blocks. I wasn’t able to find that as a contraindication listed anywhere, but patient inability to cooperate (eg agitation) is consistently listed as a relative contraindication. It seems like glaucoma might be the one that is not contraindicated for block in this scenario.
On one of the questions about the retrobulbar block anesthetizing all of the following except, cranial nerve 5 is mentioned as the facial nerve, but CN 7 is the facial nerve, and 5 is the trigeminal nerve. In this case, answer would still be CN5, as the block doesn’t block the trigeminal nerve or the facial nerve.