Adjunctive intra-operative local anaesthesia in paediatric strabismus surgery: a randomized controlled trial.
OBJECTIVE
The aim of the present study was to test the hypothesis that adjunctive local anaesthesia decreases postoperative pain, vomiting or length of stay in children having strabismus repair


METHODS
A prospective, randomized, triple-armed clinical trial involving a treatment comparison between topical amethocaine, sub-conjunctival bupivacaine and, as a placebo, topical normal saline was performed. All treatments were given at the end of surgery before emergence from the anaesthetic.


RESULTS
Overall, there was no statistically significant difference between outcome measures in the three trial groups. Using post hoc analysis there was a statistically significant difference between the groups receiving amethocaine and bupivacaine compared with the saline group in terms of the pain score at 120 min postoperatively. This difference has little clinical significance.


CONCLUSIONS
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.
Carden
S M
SM
Department of Ophthalmology, Royal Children's Hospital, Melbourne, Victoria, Australia.
Colville
D J
DJ
Davidson
A J
AJ
McKenzie
I M
IM
Mackey
D A
DA
McKenzie
J
J
Elder
J E
JE
D000293:Adolescent; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D013285:Strabismus / Q000601:surgery*; D013748:Tetracaine / Q000008:administration & dosage; D016896:Treatment Outcome; D014839:Vomiting / Q000517:prevention & control*
D000779:Anesthetics, Local; D013748:Tetracaine; D002045:Bupivacaine