ADJUNCTIVE INTRAOPERATIVE LOCAL-ANESTHESIA IN PEDIATRIC STRABISMUS SURGERY - A RANDOMIZED CONTROLLED TRIAL

Purpose: The aim of the present study was to test the hypothesis that adjunctive local anaesthesia decreases postoperative pain, vomiting or length of stay in children having strabismus repair: Method: A prospe ctive, randomized, triple-armed clinical trial involving a treatment c omparison between topical amethocaine, sub-conjunctival bupivacaine an d, as a placebo, topical normal saline was performed. Ail treatments w ere given at the end of surgery before emergence from the anaesthetic. Results: Overall, there was no statistically significant difference b etween outcome measures in the three trial groups, Using post hoc anal ysis there was a statistically significant difference between the grou ps receiving amethocaine and bupivacaine compared with the saline grou p in terms of the pain score at 120 min postoperatively. This differen ce has little clinical significance. Conclusions: Neither topical amet hocaine nor subconjunctival bupivacaine makes a clinically significant difference to postoperative pain, emesis or length of stay. Moderate dose paracetamol per rectum alone appears to be effective analgesia fo r strabismus surgery, although it probably masked any small adjunctive effect of the topical anaesthesia used in the present. trial.