Effectiveness of sub-Tenon's block in pediatric strabismus surgery
Background and objectives: Strabismus surgery is a frequently performed pediatric ocular procedure. A frequently occurring major problem in patients receiving this treatment involves the oculocardiac reflex. This reflex is associated with an increased incidence of postoperative nausea, vomiting, and...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2015-09-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001414000219 |
| _version_ | 1811236757603090432 |
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| author | Kasim Tuzcu Mesut Coskun Esra Ayhan Tuzcu Murat Karcioglu Isil Davarci Sedat Hakimoglu Suzan Aydın Selim Turhanoglu |
| author_facet | Kasim Tuzcu Mesut Coskun Esra Ayhan Tuzcu Murat Karcioglu Isil Davarci Sedat Hakimoglu Suzan Aydın Selim Turhanoglu |
| author_sort | Kasim Tuzcu |
| collection | DOAJ |
| description | Background and objectives: Strabismus surgery is a frequently performed pediatric ocular procedure. A frequently occurring major problem in patients receiving this treatment involves the oculocardiac reflex. This reflex is associated with an increased incidence of postoperative nausea, vomiting, and pain. The aim of this study was to investigate the effects of a sub-Tenon's block on the oculocardiac reflex, pain, and postoperative nausea and vomiting. Methods: Forty patients aged 5–16 years with American Society of Anesthesiologists status I–II undergoing elective strabismus surgery were included in this study. Patients included were randomly assigned into two groups by using a sealed envelope method. In group 1 (n = 20), patients did not receive sub-Tenon's anesthesia. In group 2 (n = 20), following intubation, sub-Tenon's anesthesia was performed with the eye undergoing surgery. Atropine use, pain scores, oculocardiac reflex, and postoperative nausea and vomiting incidences were compared between groups. Results: There were no significant differences between groups with regard to oculocardiac reflex and atropine use (p > 0.05). Pain scores 30 min post-surgery were significantly lower in group 2 than in group 1 (p < 0.05). Additional analgesic needed during the postoperative period was significantly lower in group 2 compared to group 1 (p < 0.05). Conclusions: In conclusion, we think that a sub-Tenon's block, combined with general anesthesia, is not effective and reliable in decreasing oculocardiac reflex and postoperative nausea and vomiting. However, this method is safe for reducing postoperative pain and decreasing additional analgesia required in pediatric strabismus surgery. Resumo: Justificativa e objetivo: A cirurgia de estrabismo é um procedimento oftalmológico comum em pediatria. Um grande problema que ocorre com frequência em pacientes submetidos a esse tratamento envolve o reflexo oculocardíaco. Esse reflexo está associado ao aumento da incidência de náusea, vômito e dor. O objetivo deste estudo foi investigar os efeitos do bloqueio subtenoniano sobre o reflexo oculocardíaco, a dor, a náusea e o vômito no período pós-operatório. Métodos: Foram incluídos no estudo 40 pacientes entre 5-16 anos, estado físico ASA I-II, submetidos à cirurgia eletiva de estrabismo. Foram randomicamente alocados em dois grupos, com o método de envelope lacrado. No Grupo 1 (n = 20),pacientes não receberam bloqueio subtenoniano. No Grupo 2 (n = 20), após a intubação, o bloqueio subtenoniano foi feito no olho submetido à cirurgia. Uso de atropina, escores de dor, reflexo oculocardíaco e incidência de náusea e vômito foram comparados. Resultados: Não houve diferença significativa entre os grupos em relação ao reflexo oculocardíaco e ao uso de atropina (p > 0,05). Os escores de dor em 30 minutos de pós-operatório foram significativamente menores no Grupo 2 do que no Grupo 1 (p < 0,05). A necessidade de analgésico adicional durante o período pós-operatório foi significativamente menor no Grupo 2 do que no Grupo 1 (p < 0,05). Conclusões: O bloqueio subtenoniano, em combinação com anestesia geral, não é eficaz e confiável para diminuir o reflexo oculocardíaco, bem como náusea e vômito pós-operatórios (NVPO). Porém, esse método é seguro para diminuir a dor no período pós-operatório e reduzir a analgesia adicional necessária em cirurgia de estrabismo pediátrico. Keywords: Sub-Tenon's block, Pediatric strabismus surgery, Anesthesia, Palavras-chave: Bloqueio subtenoniano, Cirurgia de estrabismo pediátrico, Anestesia |
| first_indexed | 2024-04-12T12:13:42Z |
| format | Article |
| id | doaj.art-8c82991576804ae3b2e05b5beda798f4 |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T12:13:42Z |
| publishDate | 2015-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-8c82991576804ae3b2e05b5beda798f42022-12-22T03:33:30ZengElsevierBrazilian Journal of Anesthesiology0104-00142015-09-01655349352Effectiveness of sub-Tenon's block in pediatric strabismus surgeryKasim Tuzcu0Mesut Coskun1Esra Ayhan Tuzcu2Murat Karcioglu3Isil Davarci4Sedat Hakimoglu5Suzan Aydın6Selim Turhanoglu7Department of Anesthesiology and Reanimation, Medical Faculty of the Mustafa Kemal University, Hatay, Turkey; Corresponding author.Department of Ophthalmology, Medical Faculty of the Mustafa Kemal University, Hatay, TurkeyDepartment of Ophthalmology, Medical Faculty of the Mustafa Kemal University, Hatay, TurkeyDepartment of Anesthesiology and Reanimation, Medical Faculty of the Mustafa Kemal University, Hatay, TurkeyDepartment of Anesthesiology and Reanimation, Medical Faculty of the Mustafa Kemal University, Hatay, TurkeyDepartment of Anesthesiology and Reanimation, Medical Faculty of the Mustafa Kemal University, Hatay, TurkeyDepartment of Anesthesiology and Reanimation, Medical Faculty of the Mustafa Kemal University, Hatay, TurkeyDepartment of Anesthesiology and Reanimation, Medical Faculty of the Mustafa Kemal University, Hatay, TurkeyBackground and objectives: Strabismus surgery is a frequently performed pediatric ocular procedure. A frequently occurring major problem in patients receiving this treatment involves the oculocardiac reflex. This reflex is associated with an increased incidence of postoperative nausea, vomiting, and pain. The aim of this study was to investigate the effects of a sub-Tenon's block on the oculocardiac reflex, pain, and postoperative nausea and vomiting. Methods: Forty patients aged 5–16 years with American Society of Anesthesiologists status I–II undergoing elective strabismus surgery were included in this study. Patients included were randomly assigned into two groups by using a sealed envelope method. In group 1 (n = 20), patients did not receive sub-Tenon's anesthesia. In group 2 (n = 20), following intubation, sub-Tenon's anesthesia was performed with the eye undergoing surgery. Atropine use, pain scores, oculocardiac reflex, and postoperative nausea and vomiting incidences were compared between groups. Results: There were no significant differences between groups with regard to oculocardiac reflex and atropine use (p > 0.05). Pain scores 30 min post-surgery were significantly lower in group 2 than in group 1 (p < 0.05). Additional analgesic needed during the postoperative period was significantly lower in group 2 compared to group 1 (p < 0.05). Conclusions: In conclusion, we think that a sub-Tenon's block, combined with general anesthesia, is not effective and reliable in decreasing oculocardiac reflex and postoperative nausea and vomiting. However, this method is safe for reducing postoperative pain and decreasing additional analgesia required in pediatric strabismus surgery. Resumo: Justificativa e objetivo: A cirurgia de estrabismo é um procedimento oftalmológico comum em pediatria. Um grande problema que ocorre com frequência em pacientes submetidos a esse tratamento envolve o reflexo oculocardíaco. Esse reflexo está associado ao aumento da incidência de náusea, vômito e dor. O objetivo deste estudo foi investigar os efeitos do bloqueio subtenoniano sobre o reflexo oculocardíaco, a dor, a náusea e o vômito no período pós-operatório. Métodos: Foram incluídos no estudo 40 pacientes entre 5-16 anos, estado físico ASA I-II, submetidos à cirurgia eletiva de estrabismo. Foram randomicamente alocados em dois grupos, com o método de envelope lacrado. No Grupo 1 (n = 20),pacientes não receberam bloqueio subtenoniano. No Grupo 2 (n = 20), após a intubação, o bloqueio subtenoniano foi feito no olho submetido à cirurgia. Uso de atropina, escores de dor, reflexo oculocardíaco e incidência de náusea e vômito foram comparados. Resultados: Não houve diferença significativa entre os grupos em relação ao reflexo oculocardíaco e ao uso de atropina (p > 0,05). Os escores de dor em 30 minutos de pós-operatório foram significativamente menores no Grupo 2 do que no Grupo 1 (p < 0,05). A necessidade de analgésico adicional durante o período pós-operatório foi significativamente menor no Grupo 2 do que no Grupo 1 (p < 0,05). Conclusões: O bloqueio subtenoniano, em combinação com anestesia geral, não é eficaz e confiável para diminuir o reflexo oculocardíaco, bem como náusea e vômito pós-operatórios (NVPO). Porém, esse método é seguro para diminuir a dor no período pós-operatório e reduzir a analgesia adicional necessária em cirurgia de estrabismo pediátrico. Keywords: Sub-Tenon's block, Pediatric strabismus surgery, Anesthesia, Palavras-chave: Bloqueio subtenoniano, Cirurgia de estrabismo pediátrico, Anestesiahttp://www.sciencedirect.com/science/article/pii/S0104001414000219 |
| spellingShingle | Kasim Tuzcu Mesut Coskun Esra Ayhan Tuzcu Murat Karcioglu Isil Davarci Sedat Hakimoglu Suzan Aydın Selim Turhanoglu Effectiveness of sub-Tenon's block in pediatric strabismus surgery Brazilian Journal of Anesthesiology |
| title | Effectiveness of sub-Tenon's block in pediatric strabismus surgery |
| title_full | Effectiveness of sub-Tenon's block in pediatric strabismus surgery |
| title_fullStr | Effectiveness of sub-Tenon's block in pediatric strabismus surgery |
| title_full_unstemmed | Effectiveness of sub-Tenon's block in pediatric strabismus surgery |
| title_short | Effectiveness of sub-Tenon's block in pediatric strabismus surgery |
| title_sort | effectiveness of sub tenon s block in pediatric strabismus surgery |
| url | http://www.sciencedirect.com/science/article/pii/S0104001414000219 |
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