Effectiveness of sub-Tenon's block in pediatric strabismus surgery

Abstract

In conclusion, we think that a sub-Tenon's block, combined with general anesthesia, is not effective and reliable in decreasing oculocardiac reflex and postoperative nausea and vomiting. However, this method is safe for reducing postoperative pain and decreasing additional analgesia required in pediatric strabismus surgery.

The effect of sub-Tenon's bupivacaine on oculocardiac reflex during strabismus surgery and postoperative pain: A randomized clinical trial

“…[7] This study was repeated by Tuzcu et al in 2014 and they found no significant difference in the occurrence of OCR between normal saline and bupivacaine injected groups. [8] Contrary to Tuzcu et al and in agreement with Steib et al, our results clearly demonstrated that compared to the normal saline group who received the same anesthetic regimen and underwent a similar procedure performed by the same surgeon, the sub-Tenon bupivacaine injected group had a significantly lower incidence of OCR.…”

“…[7] Tuzcu et al also reported that pain scores at 30 minutes after surgery and additional analgesic treatment needed during the postoperative period were significantly lower in the sub-Tenon bupivacaine group than in the control group. [8] Contrary to these studies, in the study performed by Ates et al, there was no significant difference in terms of postoperative analgesia in the retrobulbar block or subconjunctival local anesthetic infiltration groups compared to the control group. [16] This study was performed with only 10 patients in each group.…”

“…[2345] Sub-Tenon anesthetic injections have also been investigated for their preventive effect on OCR in pediatric strabismus surgery. [678] In 2005, Steib et al studied the efficacy of sub-Tenon injection of bupivacaine in pediatric strabismus surgery, and reported significant decrease in the incidence and severity of OCR, postoperative pain, and nausea/vomiting. [7] The occurrence of OCR, defined as a decrease in heart rate greater than 20%, in their study was 11% in the bupivacaine group versus 56% in the control group.…”

“…[7] This study was repeated by Tuzcu et al in 2014, and they found no significant differences in the occurrence of OCR between saline and bupivacaine injected groups. [8] In the present study, we primarily investigated the effects of sub-Tenon bupivacaine versus saline injection, combined with intravenous general anesthesia, in decreasing the occurrence and severity of OCR during strabismus surgery. The secondary endpoint was to evaluate the effects of sub-Tenon bupivacaine versus saline injection in prevention of postoperative pain in children undergoing strabismus surgery.…”

Prospective evaluation of anesthetic protocols during pediatric ophthalmic surgery

“…Some studies found that sub-Tenon block reduces OCR (11%–32% versus 57%–100%), PONV, and early POP for up to 30 min, 39–44 while other investigations did not find OCR and PONV reduction. 39,45 Ramachandran et al 43 did not find superiority of sub-Tenon block reducing POP as compared with intravenous fentanyl, while Morris et al 46 did not identify superiority of sub-Tenon block and local anesthetic eye drops for reducing POP as compared with the use of only local anesthetic eye drops at the end of surgery. Yousafzai et al 47 gave children topical oxybuprocaine prior to surgery, then an another drop over the exposed muscle, and administered the oxybuprocaine again at the end of the surgery.…”