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PubMed1991

[Necroses and hematomas--two local complications in intraoral conduction anesthesia. Case report].

According to the literature vascular lesions are reported in 6% of intraoral conduction anesthesia. A possible consequence is the intraarterial injection of catecholamin added local anesthetic. Due to a long lasting angiospasm necrosis of local mucosae and extraoral skin are possible. In a young female patient extraoral necrosis of parts of the skin of the lower lip and intraoral mucosa appeared, following intraoral conduction anesthesia. Subsequently a scar persisted needing a plastic cicatricotomy. Moreover sensitivity in the area of distribution of the mental nerve was deranged.

Adult↗
PubMedDate not supplied

[Periorbital hematoma as a complication of posterior peribulbar anesthesia].

We report a case of a large periorbital hematoma which furtherly extended to the ipsilateral orbit and appeared after posterior peribulbar blockade in a 70-year-old woman undergoing cataract extraction and intraocular implant. Peribulbar blockade was carried out with a 23-gauge blunt bevel Atkinson's needle introduced at the level of nasal or internal angle of the upper lid without loosing contact with the ceiling of the orbit. Anesthetic solution was bupicavaine at 0.75% with 10 U/ml of hyaluronidase, 3 ml. Usual blockade of lower lid was not carried out as with the first blockade, an almost complete paresis of extraocular muscles together with discrete conjunctival ecchymosis occurred. Ocular compression was conducted with Homan's balloon at 30 mmHg gor 30 minutes. Then, the eyeball was decompressed and a progressive increase of edema with conjunctival hemorrhage becoming bilateral was observed. Coagulation tests were normal. The incidence of conjunctival ecchymosis and palpebral hematoma with such technique ranges from 2% to 9%; it does not represent any intraoperative problem but may difficult surgery.

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