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ASRA Quiz

1. Which of the following statements about retrobulbar blocks is correct?

  1. When the patient looks in superonasal direction the inferior oblique muscle is less likely to be injured by the needle.
  2. When the patient looks in an inferomedial direction the optic nerve sheath is less likely to be injured by the needle
  3. The needle is inserted in the inferotemporal quadrant of the orbit and directed in a posterior, superior, and medial direction.
  4. All of the above are true.
  5. Non of the above are true.

2. The Retrobulbar space is equivalent to the:

  1. Epidural space
  2. Peribulbar space
  3. Pleural space
  4. Subarachnoid space
  5. Subdural space

3. Which of the following are risk factors for puncture of the globe during Retrobulbar block?

  1. Amblyopia
  2. Astigmatism
  3. Myopia
  4. Presbyopia
  5. Retinopathy of hypertension

4. Compared to Retrobulbar blocks, peribulbar blocks:

  1. Are the same technique
  2. Have a decreased risk of retrobulbur hemorrhage
  3. Have an increases risk of puncture of the globe
  4. Have an increased risk of injection into the optic sheath
  5. Have a shorter time to onset of anesthesia

5. Noxious reflexes associated with ocular manipulation include:

  1. The trigeminovagal (oculocardiac) reflex: brady-arrhythmias in response to ocular manipulation
  2. The oculorespiratory reflex: respiratory slowing in response to ocular manipulation
  3. The oculoemetic reflex: nausea and vomiting in response to ocular manipulation
  4. All of the above
  5. None of the above.

6. Which of the following is not an upper level of sedation as recognized by the Asa continuum of Depth of Sedation?

  1. Anxiolysis
  2. Conscious sedation
  3. Deep sedation
  4. General anesthesia
  5. Stupor

Please scroll down to see the answers, listed below.





























1. ANS: D
Ref: McGoldrick KE Anesthesia and the eye. In: Barash PG, Cullan BF, Stoelting RK, eds. Clinical anesthesia. 3rd ed. Philadelphia: Lippincott-Raven; 1997. p. 929-21.

2. ANS: A
Ref: Kupersmith MJ. Neuro-ophtalmologic and neurologic complications of ophthalmic anesthesia. In: Greenbaum S, ed. Ocular anesthesia. Philadelphia: W.B. Saunders Co.; 1997. p. 151-72.

3. ANS: C
Ref: Concepcion M. Acute complications and side effects of regional anesthesia. In: Brown DL, ed. Regional anesthesia and analgesia. Philadelphia: W.B. Saunders Co.; 1996. p. 446-61.

4. ANS: B
Ref: Tucker JH, Flynn JF. Head and neck regional blocks. In: Brown DL, ed. Regional anesthesia and analgesia. Philadelphia: W.B. Saunders Co.; 1996. p. 245-7

5. ANS: D
Ref: Johnson RW, Forrest FC. Anaesthesia for ophthalmic surgery. In: Prys-Roberts C, Braun Jr. BR, eds. International Practice of Anesthesia. Oxford: Butterworth-Heinemann; 1996. Vol. 2, Ch. 114, p.3-4.

6. ANS: E
Ref: American Society of Anesthesiologists. 2201 Directory of Members. P. 513.



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