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

Hasima Hajdini, Lisa M Steurer, Karen Balakas

    Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
    |July 9, 2019
    PubMed

    Insights

    Hydromorphone is more effective than fentanyl in reducing pain for children after strabismus surgery. This study suggests using hydromorphone to minimize postoperative and post-discharge pain in pediatric patients.

    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.
    Abstract

    Keywords:
    painpediatricspostoperativestrabismus surgery

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