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Sudden unexpected sneezing during the insertion of peribulbar block under propofol sedation

Abstract

The author presents a case report where, following propofol sedation for a peribulbar block, sneezing was induced once the local anaesthetic needle was placed in the orbital cavity. The physiology of sneezing is discussed, as well as the pathophysiology of the ACHOO (Autosomal Dominant Compelling Helio-Ophthalmic Outburst) syndrome, an autosomal dominant condition, present in approximately 25% of the population, where sneezing is provoked upon exposure to bright light. It is suggested that the anaesthesia induced by propofol may have sensitized patients with this condition to sneeze, since there appeared to be no other excitatory sequelae which have previously been described with propofol.

Résumé

Cette observation décrit un épisode d’étemuements survenu pendant une sédation au propofol exécutée pour un bloc péribulbaire. Les étemuements surviennent lorsque l’aiguille pénètre la cavité orbitale. La physiologie de l’étemuement est discutée ainsi que la physiopathologie du syndrome d’accès d’étemuements provoqués par la lumière intense, affection autosome dominante, présente dans 25% de la population. On suggère que l’anesthésie induite au propofol pourrait provoquer des êternuements chez les patients souffrants de cette condition bien qu’il ne semble pas que le propofol ait tendance à provoquer de l’excitation.

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Correspondence to David C. Abramson.

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Abramson, D.C. Sudden unexpected sneezing during the insertion of peribulbar block under propofol sedation. Can J Anaesth 42, 740 (1995). https://doi.org/10.1007/BF03012675

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Key words

  • anaesthetics,intravenous: propofol
  • anaesthetic techniques: regional, peribulbar block
  • complications: sneezing