The use of subtenon ropivacaine in managing strabismus with adjustable sutures.
BACKGROUND
Squint angle alterations with the use of adjustable sutures after strabismus surgery can be painful. Ropivacaine is a long-acting local anesthetic that, at low doses, produces sensory block with limited nonprogressive motor block.


METHODS
We performed a double-blind, randomized, pilot study using subtenon ropivacaine or placebo at the time of surgery in patients undergoing adjustable suture surgery. Surgery was performed by the same surgeon in each case. Later in the day, the same surgeon adjusted the sutures. At the time of adjustment, the patient recorded pain using a linear pain score, and the surgeon recorded ease of adjustment using a linear score. The results of surgery were noted at 4 weeks.


RESULTS
Ten patients were randomized to receive ropivacaine and 11 to receive placebo. All 10 of the ropivacaine group and 9 of the placebo group had suture adjustment. In the ropivacaine group, there was a significantly lower pain score (P <.05, Mann-Whitney U test) but no significant difference in ease of adjustment. There appeared to be no demonstrable difference in the results of surgery between the 2 groups.


CONCLUSIONS
Ropivacaine appears to reduce the pain of postoperative suture adjustment without adversely affecting the final outcome, although it does not appear to ease the adjustment itself. This small pilot study shows promising results in postoperative analgesia in these patients, although further larger trials are recommended.
Walters
G
G
Eye Department, Leeds General Infirmary, Leeds, United Kingdom.
Stewart
O G
OG
Bradbury
J A
JA
D000328:Adult; D000368:Aged; D000577:Amides / Q000627:therapeutic use*; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010865:Pilot Projects; D011446:Prospective Studies; D000077212:Ropivacaine; D013285:Strabismus / Q000601:surgery*; D013536:Suture Techniques
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine