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Pulmonary and Critical Care Pearls |

Respiratory Arrest in the Eye Clinic*

Marc A. Simon, MD; Gregory Cosgrove, MD; Clifford W. Zwillich, MD; Edward D. Chan, MD, FCCP
Author and Funding Information

*From the Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center and Department of Medicine, National Jewish Medical and Research Center, Denver, CO.

Correspondence to: Edward D. Chan, MD, FCCP, K613e, Goodman Building, National Jewish Medical and Research Center, 1400 Jackson St, Denver, CO 80206; e-mail: chane@njc.org



Chest. 2001;119(6):1953-1955. doi:10.1378/chest.119.6.1953
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Extract

A 66 -year-old man underwent retrobulbar anesthesia for repair of a detached retina. Anesthesia consisting of 5 mL of a 1:1 mixture of 2% lidocaine and 0.5% bupivacaine was injected with a 1-inch, 23-gauge needle into the retrobulbar space. There was no sanguinous return during pullback of the syringe plunger just before the injection. The patient had received this combination of medications during prior ophthalmologic procedures without any adverse effects. Three minutes after the injection, he became unresponsive with a respiratory rate of 3 to 5 breaths/min. Bag-mask ventilation was administered, and he was transferred to the emergency department.

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