comprasion of anesthetic efficacy and adverse effects associated with peribulbar injection of ropivacaine perfomed with and without ultrasound guidance in dogs

very similar to those obtained by the conventional per-
ibulbar injection technique (without UG). However, 
the eyes of the dogs that received peribulbar injec-
tion performance with UG, the IOP remained stable 
and the incidence of subconjunctival hemorrhage was 
lower, highlighting the need for further studies to as-
sess the potential clinical usefulness of this anesthetic 
technique.
14-02-0030r.indd 1046 11/18/2014 1:32:13 PM
AJVR, Vol 75, No. 12, December 2014 1047
a. Klauman PR. Bloquio peribulbar com ropivacaina 1% em cães. 
MS dissertation. Universidade Federal do Paraná, Cuitiba, PR, 
Brazil, 2007.
b. Ferreira JZ. Bloqueio peribulbar com ropivacaína a 0.75% para 
facectomia em cães: padronização e comparação de técnicas. MS 
dissertation, Faculdade de Odontologia, Universidade Estadual 
Paulista, Araçatuba, Brazil, 2011.
c. Schirmer reflex test, Ophthalmos Indústria e Comércio de 
Produtos Farmacêuticos LTDA, São Paulo, Brazil.
d. Cochet & Bonnet esthesiometer, Luneau Ophtalmologie, Char-
tres, France.
e. Fluorescein strips, Ophthalmos Indústria e Comércio de Produ-
tos Farmacêuticos LTDA, São Paulo, Brazil.
f. Tono-Pen XL, Medtronic, Jacksonville, Fla.
g. Bio Welch Allyn, Welch Allyn, Skaneateles Falls, NY.
h. Acepran 0.2%, Vetnil Ind e Comer de Produtos Veterinários 
LTDA, São Paulo, Brazil.
i. Propovan, Cristália Produtos Químicos e Farmacêuticos, São 
Paulo, Brazil.
j. Isoforine, Cristália Produtos Químicos e Farmacêuticos, São 
Paulo, Brazil.
k. Monitor, Cardiocap 5, Datex-Ohmeda, GE Healthcare Indus-
tries, São Paulo, Brazil.
l. Accutome B-Scan Plus Advanced, Probe B: 15 MHz, resolution: 
0.015 mm, gain: 47 e 55 dB, Accutome, Malvern, Pa.
m. Agulha hipodérmica 22-gauge 1” BD PrecisionGlide, Becton 
Dickinson Ind. Cirúrg. LTDA, Curitiba, Brazil.
n. Ropivacaine 1%, Cristália Produtos Químicos e Farmacêuticos, 
São Paulo, Brazil.
o. SAS, version 9.3, SAS Institute Inc, Cary, NC.
p. Cetorolaco de Trometamol 0.5%, Allergan, São Paulo, Brazil.
q. Tobramicina, Alcon, São Paulo, Brazil.
References
1. Carareto R, Nunes N, Sousa MG, et al. Anesthesia for oph-
thalmic surgeries in canines. Rev Port Cienc Veterinarias 
2007;102:35–42.
2. Vanetti LFA. Anestesia para oftalmologia. In: Ortenzi AV, 
Tardelli MA, eds. Anestesiologia – Sociedade de Anestesiologia do 
Estado de São Paulo. São Paulo, Brazil: Atheneu, 1996;591–606.
3. Myrna KE, Bentley E, Smith LJ. Effectiveness of injection of lo-
cal anesthetic into the retrobulbar space for postoperative an-
algesia following eye enucleation in dogs. J Am Vet Med Assoc 
2010;237:174–177.
4. Kahvegian MP. Cirurgia ocular. Técnicas de Anestesia local. In: 
Fantoni DT, Cortopassi SRG, eds. Anestesia em cães e gatos. 2nd 
ed. São Paulo, Brazil: Editora Rocca, 2010;319–332.
5. Park SA, Park YW, Son WG, et al. Evaluation of the analgesic 
effect of intracameral lidocaine hydrochloride injection on in-
traoperative and postoperative pain in healthy dogs undergoing 
phacoemulsification. Am J Vet Res 2010;71:216–222.
6. Ahn J, Jeong M, Lee E, et al. Effects of peribulbar anesthesia 
(sub-Tenon injection of a local anesthetic) on akinesia of extra-
ocular muscles, mydriasis, and intraoperative and postoperative 
analgesia in dogs undergoing phacoemulsification. Am J Vet Res 
2013;74:1126–1132.
7. Barreiro J, Barreiro TP, Rehder JRCL. Costs of local anesthesia 
technique used in ophthalmology to perform cataract surgery 
by phacoemulsification. Arq Bras Oftalmol 2004;67:51–67.
8. Cyriac IC, Pineda RII. Postoperative complications of periocu-
lar anesthesia. Int Ophthalmol Clin 2000;40:85–91.
9. Gross EM, Giuliano EA. Anesthesia for special patients: ocular 
patients. In: Thurmon JC, Tranquilli WJ, Benson GJ, eds. Lumb 
& Jones’ veterinary anaesthesia and analgesia. 4th ed. Baltimore: 
Williams & Wilkins, 2007;943.
10. Shilo-Benjamini Y, Pascoe PJ, Maggs DJ, et al. Retrobulbar and 
peribulbar regional techniques in cats: a preliminary study in 
cadavers. Vet Anaesth Analg 2013;40:623–631.
11. Oliva VNLS, Andrade AL, Bevilacqua L, et al. Anestesia peribul-
bar com ropivacaína como alternativa ao bloqueio neuromuscu-
lar para facectomia em cães. Arq Bras Med Vet Zoo 2010;62:586–
595.
12. Demirok A, Simsek S, Cinal A, et al. Peribulbar anesthesia: one 
versus two injections. Ophthalmic Surg Lasers 1997;28:998–
1001.
13. El Said TM, Kabeel MM. Comparison of classic peribulbar anes-
thesia and new entry point (single percutaneous injection tech-
nique) in vitroretinal surgery. Saudi J Anaesth 2010;4:80–85.
14. Ghali AM, Hafez A. Single-injection percutaneous peribulbar 
anesthesia with a short needle as an alternative to the dou-
ble-injection technique for cataract extraction. Anesth Analg 
2010;110:245–247.
15. Nouvellon E, Cuvillon P, Ripart J, et al. Anaesthesia for cataract 
surgery. Drugs Aging 2010;27:21–38.
16. Edge R, Navon S. Scleral perforation during retrobulbar and 
peribulbar anesthesia: risk factors and outcome in 50,000 con-
secutive injections. J Cataract Refract Surg 1999;25:1237–1244.
17. Ripart J, Lefrant JY, De La Coussaye JE, et al. Peribulbar versus 
retrobulbar anesthesia for ophthalmic surgery: an anatomical 
comparison of extraconal and intraconal injections. Anesthesiol-
ogy 2001;94:156–62.
18. Accola PJ, Bentley E, Smith LJ, et al. Development of a retrobul-
bar injection technique for ocular surgery and analgesia in dogs. 
J Am Vet Med Assoc 2006;229:220–225.
19. Morath U, Luyet C, Spadavecchia C, et al. Ultrasound-guided 
retrobulbar nerve block in horses: a cadaveric study. Vet Anaesth 
Analg 2013;40:205–211.
20. Perlas A, Chan VW, Simons M. Brachial plexus examination and 
localization using ultrasound and electrical stimulation: a vol-
unteer study. Anesthesiology 2003;99:429–435.
21. Spence BC, Sites BD, Beach ML. Ultrasound-guided musculo-
cutaneous nerve block: a description of a novel technique. Reg 
Anesth Pain Med 2005;30:198–201.
22. Casati A, Baciarello M, Di Cianni S, et al. Effects of ultrasound 
guidance on the minimum effective anaesthetic volume required 
to block the femoral nerve. Br J Anaesth 2007;98:823–827.
23. Tran TMN, Ivanusic JJ, Hebbard P, et al. Determination of spread 
of injectate after ultrasound-guided transversus abdominis 
plane block: a cadaveric study. Br J Anaesth 2009;102:123–127.
24. Costa-Farré C, Blanch XS, Cruz JI, et al. Ultrasound guidance 
for the performance of sciatic and saphenous nerve blocks in 
dogs. Vet J 2011;187:221–224.
25. Campoy L, Bezuidenhout AJ, Gleed RD, et al. Ultrasound-guid-
ed approach for axillary brachial plexus, femoral nerve, and sci-
atic nerve blocks in dogs. Vet Anaesth Analg 2010;37:144–153.
26. Schroeder CA, Snyder LBC, Tearney CC, et al. Ultrasound-guid-
ed transversus abdominis plane block in the dog: an anatomical 
evaluation. Vet Anaesth Analg 2011;38:267–271.
27. Mahler SP. Ultrasound guidance to approach the femoral nerve 
in the iliopsoas muscle: a preliminary study in the dog. Vet An-
aesth Analg 2012;39:550–554.
28. Echeverry DF, Laredo FG, Gil F, et al. Ultrasound-guided ‘two-
in-one’ femoral and obturator nerve block in the dog: an ana-
tomical study. Vet Anaesth Analg 2012;39:611–617.
29. da Cunha AF, Strain G, Rademacher N, et al. Palpation and ul-
trasound-guided brachial plexus blockade in Hispaniolan Ama-
zon parrots (Amazona ventralis). Vet Anaesth Analg 2013;40:96–
102.
30. De Vlamynck CA, Pille F, Hauspie S, et al. Evaluation of three 
approaches for performing ultrasonography-guided anes-
thetic blockade of the femoral nerve in calves. Am J Vet Res 
2013;74:750–756.
31. Luyet C, Eichenberger U, Moriggl B, et al. Real-time visualiza-
tion of ultrasound-guided retrobulbar blockade: an imaging 
study. Br J Anaesth 2008;101:855–859.
32. Lundblad M, Eksborg S, Lonnqvist PA. Secondary spread of