Peribulbar Block (PBB) for Cataract Surgery, Medicine and Techniques

Peribulbar Block (PBB) A peribulbar block is a regional anesthetic technique that involves injecting a local anesthetic into the eye's extraconal compartment. It's commonly used for cataract surgery and intraocular lens implantation.  Anesthesia Medicine Used in PBB A combination of local anesthetics and adjuvants is used for better anesthesia. Local Anesthetics Lidocaine (Lignocaine) 2% – 3 to 5 mL Bupivacaine 0.5% – 3 to 5 mL Ropivacaine 0.75% – Alternative to Bupivacaine Adjuvants (Optional) Hyaluronidase (3-7.5 IU/mL) → Enhances diffusion Epinephrine/Adrenaline (1:200,000) → Prolongs action Dexmedetomidine/Clonidine → Prolongs analgesia Dose and Volume Used Total volume injected: 6 to 10 mL at two sites for better anesthesia. Injection Sites (PBB Location) Primary injection site: Inferotemporal region (about 4 mL medicine) and just space below supraorbital notch (about 1 mL to 2 mL ) . A secondary site is the medial canthus if needed. Needle Type Used Needle type: 23G or 25G blunt-tipped n…