Comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastoma

Purpose: Enucleation performed in children with retinoblastoma is associated with severe postoperative pain. The use of opioids for the pain is associated with numerous complications which demand careful monitoring. Subtenon infiltration and peribulbar block are useful in ameliorating pain periopera...

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Main Authors: Ramkumar Kalaiyarasan, Dilip Shende, Magesh Parthiban, Neiwete Lomi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=8;spage=2106;epage=2110;aulast=Kalaiyarasan
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author Ramkumar Kalaiyarasan
Dilip Shende
Magesh Parthiban
Neiwete Lomi
author_facet Ramkumar Kalaiyarasan
Dilip Shende
Magesh Parthiban
Neiwete Lomi
author_sort Ramkumar Kalaiyarasan
collection DOAJ
description Purpose: Enucleation performed in children with retinoblastoma is associated with severe postoperative pain. The use of opioids for the pain is associated with numerous complications which demand careful monitoring. Subtenon infiltration and peribulbar block are useful in ameliorating pain perioperatively following various ophthalmic surgeries which are yet to be evaluated in enucleation. Therefore, we designed this study to compare the effects of peribulbar block and subtenon infiltration on postoperative pain with opioids in pediatric enucleation surgeries. Methods: 60 children of American Society of Anesthesiologists grade I and II, age ranging from 6 months to 6 years with retinoblastoma undergoing enucleation surgery were included in the study. Group A (n = 20): received peribulbar block (peribulbar group); Group B (n = 20): received subtenon local infiltration (subtenon group); and Group C (n = 20): no block was given. Results: The postoperative fentanyl consumption was lowest with Group B compared to Group A and Group C (P value 0.001). However, the total fentanyl consumption was comparable between groups A and B, while it was significantly higher in the control group. The mean pain score face, legs, activity, cry, consolability (FLACC) scale and mean time to discharge from post anesthesia care unit were lowest in Group B followed by Group A, while Group C had the highest. There was no statistically significant difference among the 3 groups with regards to side effects. Conclusion: Subtenon infiltration showed significantly better outcomes when compared to peribulbar block and intravenous opioids alone without any untoward adverse effects.
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spelling doaj.art-5ee7ab3e8d654d1a92390e61a17d325c2022-12-21T21:31:09ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892021-01-016982106211010.4103/ijo.IJO_2829_20Comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastomaRamkumar KalaiyarasanDilip ShendeMagesh ParthibanNeiwete LomiPurpose: Enucleation performed in children with retinoblastoma is associated with severe postoperative pain. The use of opioids for the pain is associated with numerous complications which demand careful monitoring. Subtenon infiltration and peribulbar block are useful in ameliorating pain perioperatively following various ophthalmic surgeries which are yet to be evaluated in enucleation. Therefore, we designed this study to compare the effects of peribulbar block and subtenon infiltration on postoperative pain with opioids in pediatric enucleation surgeries. Methods: 60 children of American Society of Anesthesiologists grade I and II, age ranging from 6 months to 6 years with retinoblastoma undergoing enucleation surgery were included in the study. Group A (n = 20): received peribulbar block (peribulbar group); Group B (n = 20): received subtenon local infiltration (subtenon group); and Group C (n = 20): no block was given. Results: The postoperative fentanyl consumption was lowest with Group B compared to Group A and Group C (P value 0.001). However, the total fentanyl consumption was comparable between groups A and B, while it was significantly higher in the control group. The mean pain score face, legs, activity, cry, consolability (FLACC) scale and mean time to discharge from post anesthesia care unit were lowest in Group B followed by Group A, while Group C had the highest. There was no statistically significant difference among the 3 groups with regards to side effects. Conclusion: Subtenon infiltration showed significantly better outcomes when compared to peribulbar block and intravenous opioids alone without any untoward adverse effects.http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=8;spage=2106;epage=2110;aulast=Kalaiyarasanenucleationperibulbar blockretinoblastomasubtenon block
spellingShingle Ramkumar Kalaiyarasan
Dilip Shende
Magesh Parthiban
Neiwete Lomi
Comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastoma
Indian Journal of Ophthalmology
enucleation
peribulbar block
retinoblastoma
subtenon block
title Comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastoma
title_full Comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastoma
title_fullStr Comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastoma
title_full_unstemmed Comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastoma
title_short Comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastoma
title_sort comparison of peribulbar block and subtenon infiltration in pediatric enucleation for retinoblastoma
topic enucleation
peribulbar block
retinoblastoma
subtenon block
url http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=8;spage=2106;epage=2110;aulast=Kalaiyarasan
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AT dilipshende comparisonofperibulbarblockandsubtenoninfiltrationinpediatricenucleationforretinoblastoma
AT mageshparthiban comparisonofperibulbarblockandsubtenoninfiltrationinpediatricenucleationforretinoblastoma
AT neiwetelomi comparisonofperibulbarblockandsubtenoninfiltrationinpediatricenucleationforretinoblastoma