There is no doubt that a local anesthetic is sufficient for the great majority of operations on the eye. Properly used it is highly efficient. However, there are certain patients for whom general anesthesia is not only better but definitely indicated. Very young children cannot be controlled without the use of a general anesthetic. Nervous, apprehensive patients, who in their anxiety to help often ruin a perfectly executed operation for cataract or some other delicate intraocular manipulation, should be given a general anesthetic. Operations on congested, painful globes, such as those from acute glaucoma, chronic congestive glaucoma and secondary glaucoma in acutely inflamed eyes, evisceration of acutely inflamed eyes and restoration of a socket are more easily performed with general anesthesia no matter how well a local anesthetic may be administered. Extensive orbital operations are not comfortably performed with local anesthesia, and in certain cases removal of the
LAVAL J. AVERTIN ANESTHESIA FOR OPHTHALMIC OPERATIONS. Arch Ophthalmol. 1938;19(5):714–718. doi:10.1001/archopht.1938.00850170064004
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