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Evaluation of Postoperative Discomfort After Strabismus Surgery Under General Anesthesia in Children: A Prospective
Yawen Mo1, Wenjuan Zhang1, Xiangcheng Tang1
1Department of Strabismus and Amblyopia, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, People's Republic of China.
Insights
Postoperative discomfort, including nausea, vomiting, and dizziness, affects over half of children after strabismus surgery. History of motion sickness and dominant eye surgery are key risk factors for this discomfort.
Area of Science:
- Ophthalmology
- Pediatric Anesthesia
- Pain Management
Background:
- Strabismus surgery is frequently performed in children under general anesthesia.
- Postoperative discomfort in pediatric patients following strabismus surgery is not well-studied.
- Understanding discomfort and its predictors is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate the incidence and types of postoperative discomfort in children after strabismus surgery.
- To identify risk factors associated with postoperative discomfort in this pediatric population.
Main Methods:
- A single-center prospective observational study was conducted.
- 300 children undergoing strabismus surgery under general anesthesia were included.
- Data collected included patient characteristics, preoperative anxiety, surgical details, and discomfort within 24 hours post-anesthesia.
Main Results:
- Over half (51.33%) of children experienced at least one type of postoperative discomfort.
- Common discomforts included postoperative nausea and vomiting (23.00%), dizziness (20.33%), and emergence agitation (5.33%).
- Independent predictors of discomfort were history of motion sickness and surgery on the dominant eye.
Conclusions:
- Postoperative nausea, vomiting, dizziness, and emergence agitation are common after pediatric strabismus surgery.
- Risk factors include younger age, larger strabismus angle, motion sickness history, dominant eye surgery, and inferior oblique anterior transposition surgery.
Purpose:
Strabismus surgery is most commonly performed on children under general anesthesia. However, few studies have focused on the postoperative discomfort in children after strabismus surgery. This study aimed to evaluate postoperative discomfort and the associated risk factors in children who underwent strabismus surgery under general anesthesia.
Patients And Methods:
A single-center prospective observational study including 300 children who underwent strabismus surgery after general anesthesia was conducted. Patients' characteristics, preoperative anxiety, surgical and anesthesia data, discomfort within 24 hours after postanesthesia care unit were recorded. The primary outcome was the incidence of postoperative discomfort.
Results:
Approximately 51.33% of the children complained of at least one of the following types of postoperative discomfort: postoperative nausea and vomiting (PONV) (23.00%), headache (4.33%), dizziness (20.33%) and emergence agitation (EA) (5.33%). Multivariate analysis indicated that history of motion sickness (P<0.001, odds ratio [OR]=3.72), and surgery in the dominant eye (P=0.010, OR=2.00) were independent predictors of postoperative discomfort; age was an independent predictor of EA (P<0.001, OR=0.36); prism diopter≥40 was an independent predictor of headache (P=0.005, OR=5.53); age (P=0.020, OR=1.12) and history of motion sickness (P=0.001, OR=2.80) were independent predictors of dizziness; history of motion sickness (P=0.001, OR=2.63) and surgery of inferior oblique anterior transposition (IOAT) (P=0.004, OR=3.10) were independent predictors of PONV.
Conclusion:
The most frequent postoperative symptoms in children after undergoing strabismus surgery under general anesthesia are PONV, dizziness, EA, and headache. Younger age, larger angle of strabismus, history of motion sickness, surgery on the dominant eye, and surgery of IOAT may be additional risk factors for postoperative discomfort.
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