BACKGROUND: Ophthalmologists are now encouraged to perform strabismus surgery as an outpatient procedure, but postoperative pain may be a barrier to discharge. Systemic analgesics have side effects or are contraindicated in some patients. We designed a trial to determine the efficacy of subtenons lidocaine injection at reducing postoperative pain and systemic analgesia requirements. METHODS:Children having unilateral primary horizontal muscle surgery were randomized to either receive an injection of 1 mL of 2% lidocaine into the inferonasal subtenons space or not. The child's parents, who were masked to the intervention, assessed pain over 4 hours postoperatively using an objective pain-scoring tool. RESULTS: Seventeen children received injections and 14 did not. Five of the subtenons group required additional analgesia (29%) compared to 9 of the controls (64%, chi(2): P =.052). The pain scores at each time interval tended to be lower in the treatment group, compared to controls, statistically significantly so at the 2-hour observation (Mann-Whitney U test: P =.01). CONCLUSIONS: These data provide some evidence of an association between the use of subtenons lidocaine injection and a reduction of pain experienced by children in the immediate postoperative period following primary strabismus surgery.
RCT Entities:
BACKGROUND: Ophthalmologists are now encouraged to perform strabismus surgery as an outpatient procedure, but postoperative pain may be a barrier to discharge. Systemic analgesics have side effects or are contraindicated in some patients. We designed a trial to determine the efficacy of subtenons lidocaine injection at reducing postoperative pain and systemic analgesia requirements. METHODS:Children having unilateral primary horizontal muscle surgery were randomized to either receive an injection of 1 mL of 2% lidocaine into the inferonasal subtenons space or not. The child's parents, who were masked to the intervention, assessed pain over 4 hours postoperatively using an objective pain-scoring tool. RESULTS: Seventeen children received injections and 14 did not. Five of the subtenons group required additional analgesia (29%) compared to 9 of the controls (64%, chi(2): P =.052). The pain scores at each time interval tended to be lower in the treatment group, compared to controls, statistically significantly so at the 2-hour observation (Mann-Whitney U test: P =.01). CONCLUSIONS: These data provide some evidence of an association between the use of subtenons lidocaine injection and a reduction of pain experienced by children in the immediate postoperative period following primary strabismus surgery.
Authors: Mohammad Reza Talebnejad; Saeed Khademi; Milad Ghani; Mohammad Reza Khalili; Mohammad Hossein Nowroozzadeh Journal: J Ophthalmic Vis Res Date: 2017 Jul-Sep