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Abstract
Purpose: Pain is the main cause of patient distress/dissatisfaction after strabismus surgery. The aim of the study was to evaluate the effect of sub-Tenon’s block with ropivacaine at the end of strabismus surgery on post-operative pain.
Methods: A prospective trial was conducted in 79 patients (age 1.0–65 years) scheduled for outpatient primary strabismus surgery with fixed sutures under general anesthesia (GA) at a major tertiary hospital. Half the patients were randomly allocated to receive sub-Tenon’s block with ropivacaine 0.2% at conclusion of the operation. Primary outcome measures were visual analog scale (VAS) scores at arrival to the post-anesthesia care unit (PACU), at discharge 3 hr later, 12–16 hr post-operatively, and 24 hr post-operatively. Supplemental analgesia requirements and patient satisfaction were recorded as well. Data were presented as median (range). Mann–Whitney test, Pearson χ2-test or Fisher’s exact test was used for statistical analysis; p ≤ 0.05 was considered significant.
Results: There were no between-group differences in median VAS scores at arrival to the PACU and at discharge, with a borderline difference at 24 hr post-operatively (p = 0.06). At 12–16 hr post-operatively, the median score was 0.0 (range 0–5) in the study group and 4.0 (range 0–6) in the controls (p < 0.001). The lower VAS score in the study group was associated with a lower rate of supplemental analgesia use (21.9% versus 57.9%, p = 0.001), fewer doses of supplemental analgesia (10 doses versus 35, p = 0.03), and higher patient satisfaction (p < 0.001).
Conclusions: Sub-Tenon’s block with ropivacaine 0.2% at the completion of outpatient primary strabismus surgery with fixed sutures under GA reduces pain 12–16 hr post-operatively and analgesia requirements 4–23 hr post-operatively.
ACKNOWLEDGMENT
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.