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Published on: October 13, 2017
[Use of MEOPA during nasolacrimal duct probing in children]
E Lala-Gitteau1, S Majzoub, P-J Pisella
1Service d'Ophtalmologie, CHU de Tours, Hôpital Bretonneau, Tours. gitteau.lala@free.fr
Insights
Nasolacrimal duct probing using inhalation of MEOPA (an equimolar mixture of nitrous oxide and oxygen) is an effective and safe alternative for infant tear duct obstruction. This method alleviates pain and avoids general anesthesia in many cases.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Anesthesiology
Background:
- Congenital nasolacrimal duct obstruction impacts over 6% of newborns.
- Treatment options include early probing with topical anesthesia or later probing under general anesthesia.
- Nasolacrimal probing with MEOPA inhalation is presented as a novel therapeutic approach.
Purpose of the Study:
- To evaluate the efficacy and feasibility of nasolacrimal duct probing using MEOPA inhalation in children.
- To assess MEOPA as a safe and effective alternative to general anesthesia for this procedure.
Main Methods:
- A prospective study involved 63 children (75 eyes) undergoing nasolacrimal duct probing with MEOPA inhalation.
- Efficacy was determined through medical staff and parent observations and procedure feasibility.
- Children ranged from 4 to 28 months in age.
Main Results:
- Successful symptom resolution occurred in 79% of cases after a single probing.
- No adverse incidents were reported during the procedure.
- Failure occurred in 21% of cases, necessitating further intervention with general anesthesia.
Conclusions:
- MEOPA inhalation is a simple, fast, low-risk, inexpensive, and effective method for pediatric procedures.
- Using MEOPA for nasolacrimal duct probing offers a viable alternative to manage pain in younger children and avoid general anesthesia in older ones.
Background:
Congenital nasolacrimal duct obstruction affects more than 6% of newborns. Whereas some recommend nasolacrimal probing under general anesthesia from 1 year of age when the condition does not spontaneously resolve, some decide in favor of early probing from 4 to 6 months of age with topical anesthesia. We present nasolacrimal probing with inhalation of MEOPA, an equimolar mixture of nitrous oxide and oxygen, as a therapeutic alternative.
Patients And Methods:
We conducted a descriptive, prospective study including 63 children (75 eyes) who had nasolacrimal duct probing with inhalation of MEOPA between March 2005 and March 2006, in consultation. Efficacy was estimated by the observation of medical staff and parents and by the feasibility of the probing procedure.
Results:
Children were 4-28 months old (mean age, 11.5 months). Symptoms resolved spontaneously in 79% of cases after only one probing. No incident was observed. In case of failure, probing with nasolacrimal intubation with nasal endoscopy and general anesthesia was done (21% of cases, mean age, 17.5 months).
Discussion:
Administration of MEOPA, by inhalation with a facial mask, is already used for minor pediatric surgical procedures. It is simple to use, fast, low-risk, inexpensive, and effective.
Conclusion:
Use of MEOPA in nasolacrimal duct probing in children could be a good alternative, making it possible to alleviate pain in the youngest children and general anesthesia in the oldest.
