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M. Absolon, B. Morris, S. Haider, S.L. Evans, J. Hall, P. Watts; Does Subtenon’s Levobupivacaine Administered Pre–Operatively Reduce Post–Operative Pain in Paediatric Strabismus Surgery? . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2964.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To assess if local infiltration of levobupivacaine while the patient is under general anaesthesia is effective in providing post–operative analgesia in children undergoing strabismus surgery. Methods: A prospective randomised controlled trial was carried out. 44 subjects were recruited and randomised to receive either subtenon’s levobupivacaine at the beginning of the operation or topical anaesthetic drops at the end of the operation. Exclusion criteria included age < 1 year or > 16 years, previous strabismus surgery, learning disability and allergy to the agents used. Pain was assessed using the Wong Baker scoring tool and recorded at 30 minutes, 1, 2, 4, 6, and 24 hours post–operatively. The nurse or parents recording pain scores were not aware which substance had been received. The presence of nausea and vomiting and time to discharge were also recorded. Results:The pain scores were consistently higher in the levobupivacaine group with an overall mean pain score of 1.48 compared to 0.93 in the control group. However these results were not statistically significant. There was no difference in nausea and vomiting or time to discharge between the two groups. Conclusions: Post–operative pain is often underestimated in children undergoing strabismus surgery and can be difficult to treat due to nausea and vomiting. Subtenon’s levobupivacaine, which is widely used for post–operative pain relief in paediatric strabismus surgery, may not be an effective form of treatment.
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