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Nothing to Sneeze At!
AHHH-CHOO!!!
Although this specific WebMD blog is devoted to the marvels of vision this post marks the second time I find myself talking about sneezing!
A while back I wrote about photic sneezing, a harmless natural reflex that results when a bright light is shined into someone's eye. It happens frequently in the clinic so I always keep a few extra boxes of tissue nearby!
Now we learn about a different kind of sneezing phenomenon - and this one carries a warning label! It's called 'injection sneezing'.
Here's what happens: when people are awake for surgery involving the eye or orbit they often receive an injection of local anesthetic to numb the tissues surrounding the eye (periocular anesthesia). Most of the time a small dose of intravenous sedation is administered to relax the patient, but the patient is technically still awake (yet carefree!)
Surgeons from Albany Medical Center noticed a trend. Sedated patients experienced a vigorous sneeze at the time the local anesthetic was injected. You can imagine the potential for disaster as somebody launches a forceful sneeze while a very sharp needle is near the eyeball. The eye could be perforated, delicate anatomy could be traumatized, bleeding could ensue, and infection could always make any complication worse.
So, how real is the risk of unwanted sneezing? These doctors reviewed over 700 cases involving periocular anesthesia. When the patient received IV sedation, sneezing occurred 5% of the time - once in every 20 cases. Interestingly, when no IV sedation was used no sneezing was observed whatsoever.
How can this information be helpful to you? If you are scheduled for eye surgery that involves IV sedation, make sure you and your doctor agree on the need for periocular anesthesia. If the surgeon deems that periocular anesthesia is necessary there are extra precautions that can be taken to protect vulnerable patients.
REFERENCE: American Journal of Ophthalmology, July 2008, pp 31-35.
Related Topics: Technorati Tags: photic sneezing, injection sneezing, periocular anesthesia, eye surgery
Although this specific WebMD blog is devoted to the marvels of vision this post marks the second time I find myself talking about sneezing!
A while back I wrote about photic sneezing, a harmless natural reflex that results when a bright light is shined into someone's eye. It happens frequently in the clinic so I always keep a few extra boxes of tissue nearby!
Now we learn about a different kind of sneezing phenomenon - and this one carries a warning label! It's called 'injection sneezing'.
Here's what happens: when people are awake for surgery involving the eye or orbit they often receive an injection of local anesthetic to numb the tissues surrounding the eye (periocular anesthesia). Most of the time a small dose of intravenous sedation is administered to relax the patient, but the patient is technically still awake (yet carefree!)
Surgeons from Albany Medical Center noticed a trend. Sedated patients experienced a vigorous sneeze at the time the local anesthetic was injected. You can imagine the potential for disaster as somebody launches a forceful sneeze while a very sharp needle is near the eyeball. The eye could be perforated, delicate anatomy could be traumatized, bleeding could ensue, and infection could always make any complication worse.
So, how real is the risk of unwanted sneezing? These doctors reviewed over 700 cases involving periocular anesthesia. When the patient received IV sedation, sneezing occurred 5% of the time - once in every 20 cases. Interestingly, when no IV sedation was used no sneezing was observed whatsoever.
How can this information be helpful to you? If you are scheduled for eye surgery that involves IV sedation, make sure you and your doctor agree on the need for periocular anesthesia. If the surgeon deems that periocular anesthesia is necessary there are extra precautions that can be taken to protect vulnerable patients.
REFERENCE: American Journal of Ophthalmology, July 2008, pp 31-35.
Related Topics: Technorati Tags: photic sneezing, injection sneezing, periocular anesthesia, eye surgery
