A Randomized Controlled Trial to Compare Pain Medications in Children Undergoing Strabismus Surgery

Area of Science:

• Pediatric Anesthesiology
• Ophthalmology
• Pain Management

Background:

• Strabismus surgery is common in children.
• Effective pain management is crucial for pediatric surgical recovery.
• Optimizing intraoperative analgesia can improve patient outcomes.

Purpose of the Study:

• To determine the optimal intraoperative analgesic combination for pediatric strabismus surgery.
• To compare the efficacy of hydromorphone versus fentanyl in managing postoperative pain.
• To assess the impact of intraoperative analgesia on pain experienced after discharge.

Main Methods:

• Randomized controlled trial comparing hydromorphone and fentanyl.
• Inclusion of 135 pediatric patients undergoing strabismus surgery.
• Postoperative pain assessment using the revised Faces, Legs, Activity, Cry, and Consolability (rFLACC) scale.
• Parental reporting of pain after discharge.

Main Results:

• Patients receiving fentanyl had significantly higher postoperative rFLACC pain scores (P = .011).
• A higher incidence of reported pain after discharge was observed in the fentanyl group (P < .001).
• Hydromorphone demonstrated superior pain control compared to fentanyl.

Conclusions:

• Hydromorphone is a more effective analgesic than fentanyl for pediatric strabismus surgery.
• Findings support a practice change towards using hydromorphone to reduce pain.
• Optimized analgesia can improve the recovery experience for children post-strabismus surgery.