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Sedated suture adjustment in children undergoing adjustable suture strabismus surgery
Warachaya Phanphruk1, Maan Alkharashi2, Aykut Bilge3
1Ophthalmology Department, Boston Children's Hospital, Boston, Massachusetts; Ophthalmology Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Summary
Sedated suture adjustment after strabismus surgery is safe for children, with no adverse events observed. However, this procedure may extend hospital stay, impacting resource utilization.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Anesthesiology
Background:
- Strabismus surgery often requires postoperative adjustments for optimal binocular alignment.
- Adjustable sutures offer flexibility but may necessitate interventions in the post-anesthesia care unit (PACU).
Purpose of the Study:
- To investigate the methods and adverse events associated with sedated suture adjustment in the PACU following strabismus surgery.
- To evaluate the safety and healthcare resource utilization of this procedure in pediatric patients.
Main Methods:
- Retrospective review of pediatric patients (≤18 years) undergoing adjustable suture strabismus surgery over three years.
- Analysis of postoperative data including time in hospital, adverse events, and surgical outcomes.
- Specific focus on patients requiring suture adjustment under sedation with propofol.
Main Results:
- 113 of 356 patients required suture adjustment; 89 were adjusted under sedation.
- No clinically significant adverse events were recorded in the sedated group (pain score ≤6/10).
- Sedated adjustment involved median propofol administration and a median anesthesiologist time of 13 minutes in the PACU.
Conclusions:
- Sedated suture adjustment is a safe method for fine-tuning binocular alignment in pediatric patients.
- While effective, the procedure can increase patient time in the hospital.
- Findings inform risk/benefit disclosure and cost-quality assessments for adjustable sutures in pediatric strabismus surgery.
