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Continuing Education in Anaesthesia, Critical Care & Pain 2005 5(3):93-97; doi:10.1093/bjaceaccp/mki025
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 5 Number 3 2005 © The Board of Management and Trustees of the British Journal of Anaesthesia [2005]. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Regional anaesthesia for intraocular surgery

Gavin Parness, BSc MB BCh, Specialist Registrar in Anaesthetics
Department of Anaesthetics, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD

Simon Underhill, MB ChB FRCA, Consultant Anaesthetist
Department of Anaesthetics, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD
E-mail: s.underhill{at}new-tr.wales.nhs.uk (for correspondence)

The first recorded use of local anaesthesia for surgery was the instillation of cocaine into the conjunctival sac in 1884 by an Austrian ophthalmologist, Karl Koller (1858–1944), at the suggestion of Sigmund Freud. In the UK, during the past 10 yr, a major change in anaesthetic practice has taken place and the majority of ophthalmic surgical patients now undergo regional rather than general anaesthesia. This change has been driven in part by the pressure to undertake surgical procedures as day cases. It is important to remember, however, that there are specific risks associated with local anaesthesia for intraocular surgery and that serious complications of general anaesthesia have always been uncommon in ophthalmology, despite the advanced age and poor state of health of many patients in this group.


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