Pain relief for strabismus surgery in children: a randomised controlled study of the use of preoperative sub-Tenon levobupivacaine.
OBJECTIVE
To compare the postoperative pain scores in children undergoing squint surgery administered with preoperative sub-Tenon levobupivacaine for postoperative pain relief versus controls.


METHODS
A prospective randomised controlled clinical trial was performed. Children aged 1-16 years undergoing strabismus surgery were recruited. The test group received sub-Tenon levobupivacaine preoperatively and topical anaesthetic eye-drops at the end of the procedure. The control group received topical anaesthetic eye-drops only at the end of surgery. Pain scores were recorded at 30 min, 2, 4, 6 and 24 h postoperatively using the Wong-Baker Pain or FLACC (face, legs, arms, cry, consolability) assessment score. The principal outcome measured was the pain score at each time interval for both groups.


RESULTS
27 patients received sub-Tenon levobupivacaine, and there were 27 age- and sex-matched controls. The pain score in the test group was not lower than that of the control group (p = 0.22 at 30 min, p = 0.37 at 2 h).


CONCLUSIONS
Sub-Tenon levobupivacaine, which is widely used for postoperative pain relief in paediatric strabismus surgery, was not effective when administered preoperatively in this cohort.
Morris
B
B
Department of Ophthalmology, University Hospital of Wales, Cardiff CF14 4XW, UK.
Watts
P
P
Zatman
T
T
Absolom
M
M
Haider
S
S
Hall
J
J
D000779:Anesthetics, Local; D002045:Bupivacaine / Q000031:analogs & derivatives; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D009883:Ophthalmic Solutions; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D011292:Premedication; D011446:Prospective Studies; D013285:Strabismus / Q000523:psychology / Q000601:surgery*; D017211:Treatment Failure
D000779:Anesthetics, Local; D009883:Ophthalmic Solutions; D000077554:Levobupivacaine; D002045:Bupivacaine