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Periocular anesthetic injection with sedation linked to reflex sneezing, study suggests
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Surgeons, anesthesia staff and other operating room personnel should be aware that periocular anesthetic injections can elicit potentially dangerous reflex sneezing when delivered under intravenous sedation to reduce ocular complications, a large retrospective study suggests.
"This is a potentially high-risk situation because the sneeze reflex generates enough force to propel the patient's head toward the periocular injection needle," the study authors said. "Awareness of this sneeze reflex phenomenon by operating room personnel may help to reduce potential morbidity."
Eric S. Ahn, MD, MS, and colleagues at Lions Eye Institute in Slingerlands, N.Y., evaluated and compared the incidence of reflex sneezing among 722 oculoplastic surgery patients who received periocular anesthetic injections either with or without intravenous sedation. Specifically, 381 patients received injections under intravenous sedation and 341 controls received injections without intravenous sedation.
Of the 381 patients who received intravenous sedation, 19 (5%) exhibited a vigorous sneeze.
"Generally, each patient would average more than one but fewer than six forceful sneezes," the authors said.
Conversely, none of the 341 controls sneezed (P = .001), they noted.
The investigators observed no adverse events or complications resulting from the sneeze reflexes, according to the study, published in the July issue of American Journal of Ophthalmology.