Efficacy and timed sequence analyses of modified single-injection peribulbar anesthesia

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Abstract
This study evaluated a modified single-injection technique of administering peribulbar anesthesia. All 150 eyes achieved complete lid anesthesia; 49 eyes (32.7%) demonstrating exophthalmos after injection achieved excellent (grade 1) instantaneous ocular akinesia. Sequence of timed events after injection included lid anesthesia (60.2 ± 15.33 seconds), lid akinesia (75.18 ± 15.33), lateral rectus akinesia (90.19 ± 2.13), inferior rectus akinesia (140.44 ± 17.51), superior rectus akinesia (229.60 ± 15.23), and medial rectus akinesia (250.42 ± 18.99). Peribulbar anesthesia, when successful, achieved complete akinesia in fewer than five minutes. In 12 eyes (8%), the peribulbar injection had to be repeated. For routine intraocular surgery, we recommend this efficacious, safe technique without the use of a separate facial block.