Cervicofacial subcutaneous emphysema and pneumomediastinum after retinal detachment surgery: just another monitored anesthesia eye case

Repair of a retinal detachment was performed during a retrobulbar block with monitored anesthesia care and intravenous conscious sedation. Following the procedure and after removal of the sterile drapes, the patient exhibited significant swelling of the bilateral orbits, face, neck, and chest. Subcutaneous emphysema and pneumomediastinum were confirmed on postoperative chest radiographs and computed tomographic scans. Possible mechanisms and potential sequelae of this intraoperative event are discussed.