Wolverhampton SUMMARYA prospective study was performed to evaluate and com pare the effect of subconjunctival bupivacaine and top ical amethocaine on pain relief after strabismus surgery.A total of 40 children scheduled for elective operation were randomly allocated to receive either subconjunc tival bupivacaine or topical amethocaine at the end of surgery. Post-operative pain was evaluated using a four point assessment score. We show that both techniques provide good post-operative pain relief. We advocate that either could be used routinely in strabismus surgery although topical amethocaine is easier to administer.The provision of optimal post-operative analgesia for chil dren undergoing strabismus surgery is an important objec tive; post-operative pain is unpleasant and may have adverse physiological and psychological effects. Good pain relief will speed recovery, reduce post-operative emotional disturbance and may facilitate early discharge. 1Pain following many paediatric procedures can be effec tively treated by local or regional analgesic techniques,2 and often no other medication will be required. This avoids the side effects of narcotics, allowing the child to return rapidly to full activity after surgery.Recently, we reported3 that a long-acting anaesthetic, such as bupivacaine 0. 5% injected subconjunctivally at the conclusion of strabismus surgery, significantly reduces post-operative pain. In this paper we continue our inves tigation of the optimum peri operative analgesia after strabismus surgery in children. As topical amethocaine is used routinely to provide conjunctival anaesthesia in oph thalmic examination and surgery, we aimed to compare the effect of subconjunctival bupivacaine and topical ame thocaine on post-operative pain relief in strabismus sur gery in children. PATIENTS AND METHODSApproval for this study was granted by the Local District
A prospective study was performed to assess the effect of subconjunctival bupivacaine on pain relief following strabismus surgery. A total of 36 children were randomly allocated to receive either subconjunctival infiltration of bupivacaine or normal saline at the conclusion of surgery. Post-operative pain was evaluated using a 4-point assessment score. Subconjunctival bupivacaine provided significantly better post-operative pain relief (P < 0.001). We suggest that it could be used routinely in strabismus surgery, as it improves post-operative comfort thereby facilitating day case surgery.
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