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Table 1 Perioperative causes of convulsions and their management and prevention

From: Convulsions during cataract surgery under peribulbar anesthesia: a case report

Causes Symptoms Management Prevention
Oculocardiac reflex Bradycardia/cardiac arrest Release of muscle tension Gentle muscle tractions
Injection of atropine Injection of atropine
Drug errors Tachycardia/bradycardia/convulsions… (depends on type of drugs injected) Symptomatic treatment Labeling of syringes
Verification of syringes before injection
Hypoglycemia Sweating, drowsiness, confusion, abnormal behavior … convulsions Administration of serum glucose (10%) No taking of hypoglycemic medications the morning of surgery
Perioperative monitoring of blood glucose
Hypoxia Desaturation, consciousness disorders … convulsions. Oxygen therapy, liberation of superior airways, intubation Monitoring of oxygen saturation
Systematic supplemental oxygen during sedation
Monitoring of sedation
Stroke Consciousness disorders, respiratory distress, hemodynamic instability, convulsions Control of airway, control of hemodynamics parameters Management of cardiovascular drugs
Neurological monitoring
Maintaining a stable hemodynamic and normal oxygenation
Toxicity of local anesthetics Somnolence, diplopia, shivering, Oxygen therapy Aspiration before injection
Difficulty speaking, arrhythmias Airway liberation Reduction of local anesthetic doses
Convulsions, coma Anticonvulsants, Use of ultrasound
Fat emulsion