title: Contact topical anesthesia for strabismus surgery in adult patients.
abstract: OBJECTIVE
  To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients.
  
  
  METHODS
  A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed.
  
  
  RESULTS
  The operation was performed successfully in all patients. Average pain intensity was 1.40 ± 1.73 during anesthesia implementation, 4.20 ± 2.57 during the surgical procedure, 2.50 ± 2.54 30 min after surgery, and 3.55 ± 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 ± 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters.
  
  
  CONCLUSIONS
  Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Miguel Servet, Zaragoza, España. Electronic address: elcorreodegeorge@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Vallés-Torres
authors.affiliation: Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: E
authors.initials: E
authors.lastname: García-Martín
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: P
authors.initials: P
authors.lastname: Peña-Calvo
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: A
authors.initials: A
authors.lastname: Sanjuan-Villarreal
authors.affiliation: Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: L M
authors.initials: LM
authors.lastname: Gil-Arribas
authors.affiliation: Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Fernández-Tirado
mesh_terms: D060433:Administration, Ophthalmic; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage; D016292:Procedural Sedation; D003320:Corneal Ulcer / Q000150:complications; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D017060:Patient Satisfaction; D010880:Piperidines / Q000627:therapeutic use; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012024:Reflex, Oculocardiac; D000077208:Remifentanil; D013285:Strabismus / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D010880:Piperidines; D008012:Lidocaine; D000077208:Remifentanil; D002045:Bupivacaine
keywords: Ambulatory surgical procedures; Anestesia local; Dolor posoperatorio; Estrabismo; Local anesthesia; Postoperative pain; Procedimientos quirúrgicos ambulatorios; Strabismus