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Topography of Peribulbar Anesthesia
  1. M. Ortiz*,
  2. R. Valls,
  3. J. Vallés*,
  4. D. Blanco* and
  5. F. Vidal*
  1. *Department of Anesthesia, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
  2. Department of Radiology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
  1. Reprint requests: M. Ortiz, M.D., Servei d'Anestesiologia, Reanimació i Terapeútica del dolor, Hospital Universitari Germans Trias i Pujol, 08016 Badalona, Barcelona, Spain.


Background and Objectives. 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.

Methods. 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.

Results. 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.

Conclusions. The median or external superior angle eyelid puncture may cause eye globe perforation.

  • regional anesthetic technique
  • peribulbar
  • imaging modality
  • computed tomography

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