A- Ocular And Bier Blocks Flashcards
Bier block AKA
IV regional block
Bier Block method
2 IVs (1 surgical, 1 sedation)
Exsanguinate arm
Double tourniquet
Inflate proximal 100mmHg above SBP
Remove wrap
Inject 40ml 0.5% lidocaine
Inflate distal after 30 minutes, then deflate proximal
Bier block
Do not deflate any cuff for how long
20 minutes
Muscle that turns eye down and out
Superior Oblique
Muscle that turns eye up and out
Inferior Oblique
Muscle turns eye up and in
Superior rectus
Muscle turns eye in (to nose)
Medial (internal) rectus
Turns eye down and in
Inferior rectus
Turns eye down and out
Lateral (external) rectus
Afferent arc of oculocardiac reflex
CN V trigeminal
Efferent arc of oculocardiac reflex
CN X Vagus
Treatment for oculocardiac reflex
STOP STIMULATION
Adequate oxygenation and ventilation
Atropine IVP 0.01-0.02mg/kg
May also need LA infiltration via retro or peribulbar block
Severe cases may need to perform CPR
Key treatment to prevent oculocardiac reflex
Retorbulbar or peribulbar block
Retrobulbar block method
Insert needle inferior of eye and perpendicular to plane of face
Once past globe axis angle medial and superior
Final needle position is within muscle cone
LA 5 ml
Retrobulbar block blocks
Optic nerve and extrinsic muscles of eye
