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[Effectiveness of sub-Tenon's block in pediatric strabismus surgery]
Kasim Tuzcu1, Mesut Coskun2, Esra Ayhan Tuzcu2
1Departamento de Anestesiologia e Reanimação, Medical Faculty of the Mustafa Kemal University, Hatay, Turquia.
Insights
A sub-Tenon's block did not effectively reduce the oculocardiac reflex or postoperative nausea and vomiting in pediatric strabismus surgery. However, it safely reduced postoperative pain and the need for additional analgesia.
Area of Science:
- Ophthalmology
- Anesthesiology
- Pediatric Surgery
Context:
- Strabismus surgery is common in children.
- The oculocardiac reflex is a significant concern, potentially causing nausea, vomiting, and pain post-surgery.
- Investigating methods to mitigate these adverse effects is crucial for patient recovery.
Purpose:
- To evaluate the efficacy of a sub-Tenon's block in managing the oculocardiac reflex during pediatric strabismus surgery.
- To assess the impact of sub-Tenon's block on postoperative pain, nausea, and vomiting.
Summary:
- This study compared outcomes in 40 pediatric patients undergoing strabismus surgery, with one group receiving a sub-Tenon's block and the other not.
- No significant difference was observed in the oculocardiac reflex or atropine use between groups.
- The sub-Tenon's block group showed significantly lower postoperative pain scores and reduced need for additional analgesics.
Impact:
- Sub-Tenon's block is a safe method for reducing postoperative pain and analgesic requirements in pediatric strabismus surgery.
- It is not effective in decreasing the oculocardiac reflex or postoperative nausea and vomiting.
- Findings guide anesthetic choices for pediatric strabismus procedures.
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:
40 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.
