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Home / Equine Research Bank / Equine Vet J / Retrobulbar lidocaine injection via the supraorbital fossa i...
Equine veterinary journal2021; doi: 10.1111/evj.13496

Retrobulbar lidocaine injection via the supraorbital fossa is safe in adult horses but produces regionally variable periocular anaesthesia.

Abstract: Injection techniques for retrobulbar anaesthesia are published in horses, but neither safety nor anaesthetic efficacy and duration have been evaluated objectively in vivo. Objective: To characterise the safety and efficacy of one published technique for retrobulbar anaesthesia. Methods: Randomised, controlled descriptive experiment. Methods: Unilateral retrobulbar injection with 10 mL lidocaine (2%) was performed in eight sedated adult mares. Contralateral eyes served as untreated controls. Neurophthalmic parameters, intraocular pressure (IOP), and corneal and periocular sensation were measured awake, post-sedation and at periodic time points for 24 hours following injection. Adverse effects were documented. Results: Injection of 10 mL lidocaine significantly increased IOP for up to 2 hours (P < .05) maximally at 30 min (mean [95% CI]: 6.0 [2.7, 9.2] mm Hg, P < .001). Six of the eight treated eyes developed mild to moderate reversible chemosis for 2 to 24 hours. One eye developed severe chemosis and superficial corneal ulceration at 24 and 48 hours following injection respectively. Corneal sensitivity significantly decreased for 6 hours (P < .05), maximally at 10 min (-44.4 [-34.6, -54.1] mm, P < .001). Periocular sensitivity (measured as increase in applied force) significantly decreased dorsally and medially for up to 2 hours (maximal at 2 hours (367.1 [238.5, 495.7] g, P < .001, and at 30 min: 345.8 [202.6, 488.9] g, P < .001) respectively). Ventral and lateral sensitivity were not effectively decreased beyond 30 min. Optic nerve function was not consistently reduced following injection. Conclusions: Investigators were not masked to the treated eye. Conclusions: Retrobulbar injection using 10 mL lidocaine is safe in normal eyes of adult horses, but carries risk in structurally compromised or glaucomatous eyes due to transient IOP increase. Reversible chemosis commonly develops 2-4h following injection, and may be severe in some horses with risk for corneal ulceration. Corneal anaesthesia is rapid and prolonged, but all periocular regions are not consistently anaesthetised. Retrobulbar injection should be combined with other local anaesthetic injections for eyelid surgeries or enucleations.
© 2021 EVJ Ltd.
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Publication Date: 2021-08-16 PubMed ID: 34396584DOI: 10.1111/evj.13496Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study investigates the effectiveness and safety of injecting lidocaine, a type of anesthetic, into the retrobulbar region (area behind the eyeball) of adult horses. The study found that this injection increases intraocular pressure and decreases ocular sensitivity but did not consistently reduce optic nerve function. In addition, it established that the technique is generally safe for horses with normal eyes but may pose risks for those with eye conditions.

Methods

  • The research was a randomized, controlled, descriptive experiment conducted on eight sedated adult mares.
  • Each horse received a unilateral retrobulbar injection with 10 mL of 2% lidocaine. The contralateral eyes (the eyes on the opposing side of where the injection was given) acted as untreated controls.
  • The researchers evaluated various neurophthalmic parameters, intraocular pressure (IOP), and the corneal and periocular (surrounding the eye) sensation. This evaluation was done when the horses were awake, after sedation, and at periodic intervals for 24 hours after the injection.
  • Any adverse effects from the injection were also noted.

Results

  • The injection of lidocaine caused a significant increase in IOP, reaching its peak at around 30 minutes after injection and lasting for up to two hours.
  • Six out of the eight treated eyes displayed mild to moderate reversible chemosis (a swelling of the surface of the eye) lasting between two to 24 hours. One eye developed severe chemosis and superficial corneal ulceration observed at 24 and 48 hours post-injection.
  • The sensitivity of the cornea significantly decreased for six hours, with its maximum reduction occurring ten minutes after the injection.
  • The sensitivity around the eyes decreased dorsally and medially for up to two hours, but sensitivity was not effectively reduced on the ventral (front) and lateral (side) regions beyond 30 minutes.
  • Optic nerve function wasn’t consistently affected by the injection.

Conclusions

  • The researchers concluded that a retrobulbar injection with 10 mL of lidocaine is safe for healthy adult horses, but it can pose risks for horses with pre-existing eye conditions or glaucoma due to the temporary increase in intraocular pressure.
  • Chemosis often develops 2-4 hours after the injection, and this swelling can be severe in some horses leading to corneal ulceration.
  • While the lidocaine injection rapidly and prolongedly numb the cornea, it doesn’t consistently numb all the regions around the eye.
  • The researchers suggested combining the retrobulbar injection with other local anesthetic injections when performing eyelid surgeries or enucleations (eye removal).

Cite This Article

APA
Yang VY, Eaton JS, Harmelink K, Hetzel SJ, Sanchez A, Lund JR, Smith LJ. (2021). Retrobulbar lidocaine injection via the supraorbital fossa is safe in adult horses but produces regionally variable periocular anaesthesia. Equine Vet J. https://doi.org/10.1111/evj.13496

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Yang, Vanessa Y
  • Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Eaton, Joshua Seth
  • Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Harmelink, Katherine
  • Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Hetzel, Scott J
  • Department of Biostatistics and Medical Informatics, Institute for Clinical and Translational Research (ICTR), University of Wisconsin-Madison, Madison, WI, USA.
Sanchez, Adriana
  • Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Lund, Jane R
  • Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Smith, Lesley J
  • Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.

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Citations

This article has been cited 1 times.
  1. Hermans H, Lloyd-Edwards RA, Ferrão-van Sommeren AJH, Tersmette AA, Schouten JCM, Serra Bragança FM, van Loon JPAM. Comparing Blind and Ultrasound-Guided Retrobulbar Nerve Blocks in Equine Cadavers: The Training Effect. Animals (Basel) 2022 Jan 9;12(2).
    doi: 10.3390/ani12020154pubmed: 35049776google scholar: lookup
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