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 |