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SUBTENON BUPIVACAINE INJECTION FOR POSTOPERATIVE PAIN RELIEF FOLLOWING PEDIATRIC STRABISMUS SURGERY: A RANDOMIZED

Radwa H Bakr, Hesham M Abdelaziz

    Middle East Journal of Anaesthesiology
    |July 1, 2015
    PubMed

    Insights

    Preoperative bupivacaine injections before strabismus surgery effectively reduced pain and side effects like nausea and vomiting in children. This method offers better postoperative pain control and fewer complications compared to standard care.

    Area of Science:

    • Anesthesiology
    • Pediatric Surgery
    • Ophthalmology

    Background:

    • Strabismus surgery in children frequently causes pain, postoperative nausea and vomiting (PONV), and oculocardiac reflex (OCR).
    • Existing systemic analgesics have limitations and contraindications.
    • Investigating alternative methods for managing perioperative adverse events is crucial.

    Purpose of the Study:

    • To evaluate the efficacy of preoperative subtenon bupivacaine injection in reducing postoperative pain and side effects in pediatric strabismus surgery.
    • To compare the incidence of OCR, PONV, and the need for additional analgesia between bupivacaine and saline groups.

    Main Methods:

    • A double-blind, randomized study involving 60 children (2-6 years old, ASA I-II) undergoing strabismus surgery.
    • Participants received either a subtenon injection of 0.5% bupivacaine or saline prior to surgery.
    • Pain scores (FLACC scale), OCR, PONV, analgesic requirements, and recovery room discharge time were assessed.

    Main Results:

    • Significantly lower pain scores were observed in the bupivacaine group at 0 and 30 minutes post-surgery.
    • The incidence of OCR and vomiting was significantly reduced in the bupivacaine group.
    • Fewer patients in the bupivacaine group required additional systemic analgesia, and recovery room discharge time was shorter.

    Conclusions:

    • Preoperative subtenon bupivacaine provides effective postoperative pain control in pediatric strabismus surgery.
    • This anesthetic technique reduces the incidence of OCR and PONV, improving patient outcomes.
    • Subtenon bupivacaine block is a valuable adjunct to general anesthesia for managing side effects in this patient population.
    Abstract

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