Efficacy of tetracaine eye drops in strabismus surgery: a systematic review and meta-analysis of randomized controlled trials

ABSTRACT

Aim

To comprehensively evaluate the efficacy and safety profile of tetracaine eye drops as a local anesthetic agent among pediatric patients undergoing for strabismus surgery.

Methods

We systemically searched four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) from inception until April 2023. We included randomized controlled trials (RCTs) comparing tetracaine and placebo or no intervention for intraoperative and postoperative outcomes in strabismus surgery patients. We used the Cochrane risk of bias-2 tool for the risk of bias assessment. Continuous variables were pooled as mean difference (MD) or standardized mean difference (SMD), and categorical variables were pooled as risk ratio (RR) with a 95% confidence interval (CI).

Results

Six RCTs were included in the meta-analysis, with a total of 326 patients. There was no significant difference between the tetracaine and the control groups regarding the mean operative time (MD = −0.10 minutes, 95% CI [−3.79, 3.59], p = .96), the mean time to first analgesia (MD = −0.87 minutes, 95% CI [−11.15, 9.40], P = .87), the mean behavior score (SMD = −S0.48, 95% CI [−1.24, 0.28], p = .22), the rate of postoperative vomiting (RR = 1.27, 95% CI [0.62, 2.61], p = .52), or the number of additional analgesia (RR = 0.55, 95% CI [0.27, 1.13], p = .10).

Conclusion

Our systematic review and meta-analysis found no significant differences in the safety and efficacy of tetracaine eye drops for strabismus surgery when compared to placebo or no intervention. Further investigation is needed to establish the best local anesthetic for strabismus surgery.

KEYWORDS:

• Behavioral
• local anesthesia
• pain
• strabismus
• tetracaine

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics committee approval

Not applicable as this study is based exclusively on published Literature.

Data availability statement

All data are available within the manuscript.

Authorship contributions

Concept: NA, S-AO, ZA, S-AM, FA, MA; Design: NA, S-AO, ZA, S-AM, FA, MA; Data collection or processing: NA, S-AO, ZA, S-AM, FA, MA; Analysis or interpretation: NA, S-AO, ZA, S-AM, FA, MA; Literature search: NA, S-AO, ZA, S-AM, FA, MA; Writing: NA, S-AO, ZA, S-AM, FA, MA; Reviewing manuscript for editorial and intellectual contents: NA, S-AO, ZA, S-AM, FA, MA; Approval of manuscript for submission: NA, S-AO, ZA, S-AM, FA, MA.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09273972.2023.2253851

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.