Related Experiment Video
Updated: Jul 8, 2026
Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
Published on: June 25, 2013
The Infratrochlear Nerve Block Reduces the Incidence of Postoperative Nausea Vomiting in Pediatric Patients
Chung-Sik Oh1,2,3, Hyun Jin Shin2,3,4, Seon-Ju Park1
1Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Seoul 05030, Republic of Korea.
Insights
The infratrochlear nerve (ITN) block significantly reduced postoperative nausea and vomiting (PONV) in pediatric strabismus surgery patients. This nerve block also lowered perioperative pain, offering a dual benefit for young patients.
Area of Science:
- Anesthesiology
- Ophthalmology
- Pediatric Surgery
Background:
- Pediatric strabismus surgery frequently leads to postoperative nausea and vomiting (PONV).
- Patient pain is a significant risk factor for developing PONV.
- The infratrochlear nerve (ITN) block is known to reduce perioperative pain in strabismus surgery.
Purpose of the Study:
- To investigate the effect of the infratrochlear nerve (ITN) block on the incidence of PONV in pediatric patients undergoing strabismus surgery.
- To evaluate the impact of ITN block on perioperative pain and anesthetic parameters.
Main Methods:
- Retrospective review of medical charts for pediatric patients (age >2 years) with exotropia undergoing strabismus surgery.
- Comparison of PONV incidence, intraoperative surgical pleth index (SPI), state entropy (SE), response entropy (RE), hemodynamics, and medication use between ITN block and no-block groups.
- Analysis included 116 patients, with 58 in each group.
Main Results:
- PONV incidence was significantly lower in the ITN block group (5.2%) compared to the no-block group (22.4%; p=0.015).
- Lower SPI values were observed in the ITN block group during conjunctiva incision, muscle dissection, and traction.
- Response entropy (RE) was significantly lower in the ITN block group during muscle dissection and traction, indicating reduced surgical stress.
Conclusions:
- The infratrochlear nerve (ITN) block is effective in reducing the incidence of PONV in pediatric strabismus surgery.
- ITN block also successfully mitigates perioperative pain in this patient population.
- This nerve block offers a promising strategy for improving outcomes in pediatric strabismus surgery.
Abstract:
Background/Objectives: Strabismus surgery in pediatric patients is associated with a high incidence of postoperative nausea and vomiting (PONV). Patients showing pain are more prone to develop PONV. As the infratrochlear nerve (ITN) block can ameliorate perioperative pain following strabismus surgery, we hypothesized that ITN block may influence PONV in pediatric patients undergoing strabismus surgery. Methods: The medical charts of pediatric patients older than 2 years with exotropia who underwent strabismus surgery under general anesthesia, with or without ITN block, were reviewed retrospectively. The incidence of PONV, intraoperative surgical pleth index (SPI), state entropy (SE), response entropy (RE), the changes in hemodynamics, and perioperative use of metoclopramide and ketoprofen were investigated. Results: The study population comprised 116 patients (58 for the No-block group vs. 58 for the ITN group). The incidence of PONV was significantly lower in the ITN block group compared to the No-block group (5.2% vs. 22.4%, respectively; p = 0.015). The SPI at conjunctiva incision, muscle dissection and traction were significantly lower in the ITN block group than in the No-block group. SE was comparable between the two groups, but RE at muscle dissection and traction was significantly lower in the ITN block group than in the No-block group. The use of metoclopramide and ketoprofen was also lower in the ITN block group than in the No-block group. Conclusions: ITN block reduced PONV as well as perioperative pain in pediatric patients undergoing strabismus surgery.
