Retrobulbar block reduces pain after strabismus surgery

Dina H. Hassanein

WASHINGTON — Retrobulbar block is beneficial in pediatric strabismus surgery, providing analgesia and lowering the level of postoperative pain, according to a study presented here.

“Our study aimed to compare the analgesic effect of retrobulbar block with intravenous fentanyl in children undergoing strabismus surgery and to evaluate the safety of retrobulbar block and record its complications,” Dina H. Hassanein, MD, FRCS, told colleagues at the American Association for Pediatric Ophthalmology and Strabismus meeting.

Fifty children aged 2 to 12 years undergoing primary bilateral horizontal rectus muscle recession with a fornix incision performed by an experienced surgeon were enrolled in the prospective, randomized, interventional, comparative, single-center study.

In one arm, 25 children received 2 mL to 4 mL of 2% lidocaine/0.5% bupivacaine using a 25-gauge needle after intubation and before starting surgery. The other arm received 1 µg/kg of intravenous fentanyl after intubation and before starting surgery.

Intraoperatively, heart rate was significantly higher in the fentanyl group (mean 136.10 bpm vs. 122.76 bpm, P = .038), although there were no significant differences between the groups with regard to systolic or diastolic blood pressure.

Postoperatively, nausea and vomiting were greater in the fentanyl group. No opioids were needed in either group.

“Only minor complications were encountered due to the retrobulbar block in the form of conjunctival chemosis and subconjunctival hemorrhage,” Hassanein said. The complications were transient and all resolved. – by Patricia Nale, ELS

Reference:

Hassanein DH. Comparison of preemptive analgesic effect of retrobulbar block and intravenous fentanyl in pediatric strabismus surgery. Presented at: American Association for Pediatric Ophthalmology and Strabismus meeting; March 18-22, 2018; Washington.

Disclosure: Hassanein reports no relevant financial disclosures.