Postoperative analgesia in children using preemptive retrobulbar block and local anesthetic infiltration in strabismus surgery. 1998

Y Ateş, and N Unal, and H Cuhruk, and N Erkan
Department of Anesthesiology and Reanimation, Ankara University, Turkey.

OBJECTIVE Postoperative pain management in pediatric strabismus patients is infrequently studied. Pediatric patients can be mobilized earlier if postoperative pain is minimized. In this study, two different regional anesthetic techniques, retrobulbar block and local infiltration, were compared with a "no block" control group for the postoperative management of pain in pediatric patients undergoing elective strabismus surgery. METHODS Thirty patients were randomly allocated to one of the study groups: group 1 (n=10) control, group 2 (n=10) retrobulbar block, and group 3 (n=10) subconjunctival bupivacaine infiltration. The parameters that were evaluated during the early postoperative period (6 hours) were circulatory, pain scores by Visual Analog Scale (VAS) and Modified Pediatric Objective Pain Scale (MPOPS), additional analgesic requirement, nausea, and vomiting. The parameters that were evaluated after discharge from the hospital (on postoperative days 1 and 2) through questionnaires were additional analgesic requirement, nausea, vomiting, sleep disturbances, activity, and appetite. RESULTS Group 3 had significantly higher VAS and MPOPS scores at postoperative 120, 180, 240, 300, and 360 minutes than groups 1 and 2 (P < .05). Patients in group 2 seemed to have a higher incidence of nausea and vomiting both in the early (6 hours) and late postoperative (postoperative days 1 and 2) periods; however, the difference was not statistically significant. Group 2 required less analgesic compared with groups 1 and 3 during the late postoperative period. Late postoperative activity and appetite were better in groups 2 and 3. CONCLUSIONS Because there was no significant difference in terms of postoperative analgesia in the retrobulbar block or subconjunctival local anesthetic infiltration groups compared with the control group, we suggest that conventional methods of pain treatment are adequate for postoperative analgesia in strabismus surgery.

UI MeSH Term Description Entries
D008297 Male Males
D009407 Nerve Block Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain. Chemical Neurolysis,Chemodenervation,Nerve Blockade,Block, Nerve,Blockade, Nerve,Blockades, Nerve,Blocks, Nerve,Chemical Neurolyses,Chemodenervations,Nerve Blockades,Nerve Blocks,Neurolyses, Chemical,Neurolysis, Chemical
D009915 Orbit Bony cavity that holds the eyeball and its associated tissues and appendages. Eye Socket,Eye Sockets,Orbits,Socket, Eye,Sockets, Eye
D010147 Pain Measurement Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies. Analgesia Tests,Analogue Pain Scale,Formalin Test,McGill Pain Questionnaire,Nociception Tests,Pain Assessment,Pain Intensity,Pain Severity,Tourniquet Pain Test,Visual Analogue Pain Scale,Analog Pain Scale,Assessment, Pain,McGill Pain Scale,Visual Analog Pain Scale,Analgesia Test,Analog Pain Scales,Analogue Pain Scales,Formalin Tests,Intensity, Pain,Measurement, Pain,Nociception Test,Pain Assessments,Pain Intensities,Pain Measurements,Pain Questionnaire, McGill,Pain Scale, Analog,Pain Scale, Analogue,Pain Scale, McGill,Pain Severities,Pain Test, Tourniquet,Questionnaire, McGill Pain,Scale, Analog Pain,Scale, Analogue Pain,Scale, McGill Pain,Severity, Pain,Test, Analgesia,Test, Formalin,Test, Nociception,Test, Tourniquet Pain,Tests, Nociception,Tourniquet Pain Tests
D010149 Pain, Postoperative Pain during the period after surgery. Acute Post-operative Pain,Acute Postoperative Pain,Chronic Post-operative Pain,Chronic Post-surgical Pain,Chronic Postoperative Pain,Chronic Postsurgical Pain,Pain, Post-operative,Persistent Postsurgical Pain,Post-operative Pain,Post-operative Pain, Acute,Post-operative Pain, Chronic,Post-surgical Pain,Postoperative Pain, Acute,Postoperative Pain, Chronic,Postsurgical Pain,Postoperative Pain,Acute Post operative Pain,Chronic Post operative Pain,Chronic Post surgical Pain,Chronic Postsurgical Pains,Pain, Acute Post-operative,Pain, Acute Postoperative,Pain, Chronic Post-operative,Pain, Chronic Post-surgical,Pain, Chronic Postoperative,Pain, Chronic Postsurgical,Pain, Persistent Postsurgical,Pain, Post operative,Pain, Post-surgical,Pain, Postsurgical,Post operative Pain,Post operative Pain, Acute,Post operative Pain, Chronic,Post surgical Pain,Post-operative Pains,Post-surgical Pain, Chronic,Postsurgical Pain, Chronic,Postsurgical Pain, Persistent
D010351 Patient Discharge The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities. Discharge Planning,Discharge Plannings,Discharge, Patient,Discharges, Patient,Patient Discharges,Planning, Discharge,Plannings, Discharge
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children

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