Adjunctive intra‐operative local anaesthesia in paediatric strabismus surgery: A randomized controlled trial

Abstract

Neither topical amethocaine nor subconjunctival bupivacaine makes a clinically significant difference to postoperative pain, emesis or length of stay. Moderate dose paracetamol per rectum alone appears to be effective analgesia for strabismus surgery, although it probably masked any small adjunctive effect of the topical anaesthesia used in the present trial.

Subtenons lidocaine injection for postoperative pain relief after strabismus surgery in children: A prospective randomized controlled trial

“…10 Topical amethocaine 1% drops and subconjunctival infiltration with bupivacaine 0.5% administered at the conclusion of strabismus surgery have been shown to be equally effective in reducing postoperative pain, [11][12][13] although another study did not show any additional analgesic effect of either of these interventions when compared to placebo. 14 Our pilot study found that a subtenons injection of lidocaine was associated with a reduction in postoperative systemic analgesia requirement (29% vs. 64% of controls, P ϭ 0.052), and with a trend to reduced pain scores that reached statistical significance at the 2-h observation. 1 The full-scale trial did not confirm the pilot study's finding of a reduction in systemic analgesia requirement in patients receiving subtenons lidocaine.…”

Pain relief for strabismus surgery in children: a randomised controlled study of the use of preoperative sub-Tenon levobupivacaine

“…Nausea and vomiting are also common after squint surgery, occurring in 18% to 54% of patients 11 12. Postoperative pain appears to be a clear predictor of nausea and vomiting in children 4.…”

Anesthetic management for pediatric strabismus surgery: Continuing Professional Development

“…48,49 There is evidence of an association between topical diclofenac 50 and excellent analgesia with a low incidence of PONV; however, this benefit has not been demonstrated with ketorolac. 49 …”

“…7,26 Analgésiques topiques L'efficacité de la tétracaïne topique a été démontrée dans deux études séparées; 46,47 toutefois, deux autres études n'ont pas montré d'avantage. 48,49 Certaines données soutiennent une association entre le diclofénac topique 50 et une excellente analgésie accompagnée d'une faible incidence de NVPO, mais cet avantage n'a pas été démontré avec le kétorolac. 49 …”