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How To Do an Ophthalmic Nerve Block
Equipment
Nonsterile gloves Barrier precautions as indicated (eg, face mask, safety glasses or face shield, cap and gown) Antiseptic solution (eg,chlorhexidine,povidone-iodine, alcohol) Injectable local anesthetic* such aslidocaine2% withepinephrine† 1:100,000 or, for longer-duration anesthesia,bupivacaine0.5% withepinephrine† 1:200,000 Syringe (eg, 3 mL) and needle (eg, 25 or 27 gauge) for anesthetic injection * Local anesthetics are discussed in Lacerations . † Maximum dose of local anesthetics:Lidocainewithoutepinephrine, 5 mg/kg;lidocainewithepinephrine, 7 mg/kg;bupivacaine, 1.5 mg/kg. NOTE: A 1% solution (of any substance) represents 10 mg/mL (1 g/100 mL).Epinephrinecauses vasoconstriction, which prolongs the anesthetic effect. Patients with cardiac disease should receive only limited amounts ofepinephrine(maximum 3.5 mL of solution containing 1:100,000epinephrine); alternatively, use local anesthetic withoutepinephrine. 