Hyaluronidase is an enzyme which degrades hyaluronan (HA) and has diverse clinical applications resulting from its ability to facilitate the dispersion and/or absorption of an array of medications and fluids. It provides rapid penetrance of anesthetic agents, particularly to locations difficult to …
Hyaluronidase
Hyaluronidase in Ophthalmology
Hyaluronidase in ophthalmology is most frequently used in combination with anesthetics for ophthalmologic surgery ( eg, retrobulbar block, peribulbar block, sub-Tenon's block, and van Lint block). The rationale for the inclusion of hyaluronidase in combination with local anesthesia techniques …
Peribulbar Block
The peribulbar block technique was developed to minimize the risk of injury to structures within the intraconal space. It is performed by injection into the extraconal space using larger volumes of local anesthetic (eg, up to 12 mL). The larger volume is necessary for its spread into the entire …
Van Lint Blocks
Because retrobulbar blocks do not provide lid akinesia, they are often combined with van Lint blocks. This method of facial nerve block was the first to be reported and is considered to be the classic technique. Typically, 5 to 10 mL of anesthetic (often the same mixture as used for the retrobulbar …
Retrobulbar Block
A Retrobulbar block may be preferred for certain procedures that would benefit from lower volumes of local anesthetic (ie, 3-5 mL). Although retrobulbar blocks are used less commonly than peribulbar blocks because of potential anatomic risk factors associated with administration and the need …
Sub-Tenon’s Block
What is Sub-Tenon's Block? A sub-Tenon's block (STB) administered using either a needle or cannula provides high-quality anesthesia of the whole globe using relatively small volumes (eg, 1.25-5 mL). The addition of hyaluronidase in STB has been studied in varying combinations across six randomized, …