Related Experiment Video
Updated: Apr 4, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Effectiveness of sub-Tenon's block in pediatric strabismus surgery
Kasim Tuzcu1, Mesut Coskun2, Esra Ayhan Tuzcu2
1Department of Anesthesiology and Reanimation, Medical Faculty of the Mustafa Kemal University, Hatay, Turkey.
Insights
Sub-Tenon's block did not reduce the oculocardiac reflex or postoperative nausea and vomiting in pediatric strabismus surgery. However, it effectively reduced postoperative pain and the need for additional analgesia.
Area of Science:
- Ophthalmology
- Anesthesiology
- Pediatric Surgery
Background:
- Strabismus surgery is common in children.
- The oculocardiac reflex is a frequent complication, leading to nausea, vomiting, and pain.
- Investigating methods to mitigate these adverse effects is crucial.
Purpose of the Study:
- To evaluate the efficacy of a sub-Tenon's block in managing the oculocardiac reflex.
- To assess the impact of sub-Tenon's block on postoperative pain, nausea, and vomiting.
- To determine the safety and effectiveness of sub-Tenon's block in pediatric strabismus surgery.
Main Methods:
- A randomized study included 40 pediatric patients (ages 5-16) undergoing strabismus surgery.
- Patients were divided into two groups: one receiving general anesthesia alone, the other receiving sub-Tenon's block post-intubation.
- Oculocardiac reflex, atropine use, pain scores, and postoperative nausea/vomiting were compared.
Main Results:
- No significant difference in oculocardiac reflex or atropine use between groups.
- Significantly lower pain scores at 30 minutes post-surgery in the sub-Tenon's block group.
- Reduced need for additional analgesics in the sub-Tenon's block group.
Conclusions:
- Sub-Tenon's block is not effective for reducing the oculocardiac reflex or postoperative nausea/vomiting in pediatric strabismus surgery.
- The procedure is safe and effective in reducing postoperative pain.
- It also decreases the requirement for additional analgesia post-surgery.
Background And Objectives:
Strabismus surgery is a frequently performed pediatric ocular procedure. A frequently occurring major problem in patients receiving this treatment involves the oculocardiac reflex. This reflex is associated with an increased incidence of postoperative nausea, vomiting, and pain. The aim of this study was to investigate the effects of a sub-Tenon's block on the oculocardiac reflex, pain, and postoperative nausea and vomiting.
Methods:
Forty patients aged 5-16 years with American Society of Anesthesiologists status I-II undergoing elective strabismus surgery were included in this study. Patients included were randomly assigned into two groups by using a sealed envelope method. In group 1 (n=20), patients did not receive sub-Tenon's anesthesia. In group 2 (n=20), following intubation, sub-Tenon's anesthesia was performed with the eye undergoing surgery. Atropine use, pain scores, oculocardiac reflex, and postoperative nausea and vomiting incidences were compared between groups.
Results:
There were no significant differences between groups with regard to oculocardiac reflex and atropine use (p>0.05). Pain scores 30min post-surgery were significantly lower in group 2 than in group 1 (p<0.05). Additional analgesic needed during the postoperative period was significantly lower in group 2 compared to group 1 (p<0.05).
Conclusions:
In conclusion, we think that a sub-Tenon's block, combined with general anesthesia, is not effective and reliable in decreasing oculocardiac reflex and postoperative nausea and vomiting. However, this method is safe for reducing postoperative pain and decreasing additional analgesia required in pediatric strabismus surgery.
