POSTOPERATIVE ANALGESIA IN CHILDREN USING PREEMPTIVE RETROBULBAR BLOCK AND LOCAL-ANESTHETIC INFILTRATION IN STRABISMUS SURGERY

Background and Objectives. Postoperative pain management in pediatric strabismus patients is infrequently studied. Pediatric patients can be mobilized earlier if postoperative pain is minimized. In this study, two different regional anesthetic techniques, retrobulbar block and lo cal infiltration, were compared with a ''no block'' control group for the postoperative management of pain in pediatric patients undergoing elective strabismus surgery. Methods. Thirty patients were randomly al located to one of the study groups: group 1 (n = 10) control, group 2 (n = 10) retrobulbar block, and group 3 (n = 10) subconjunctival bupiv acaine infiltration. The parameters that were evaluated during the ear ly postoperative period (6 hours) were circulatory, pain scores by Vis ual Analog Scale (VAS) and Modified Pediatric Objective Pain Scale (MP OPS), additional analgesic requirement, nausea, and vomiting. The para meters that were evaluated after discharge from the hospital (on posto perative days 1 and 2) through questionnaires were additional analgesi c requirement, nausea, vomiting, sleep disturbances, activity, and app etite. Results. Group 3 had significantly higher VAS and MPOPS scores at postoperative 120, 180, 240, 300, and 360 minutes than groups 1 and 2 (P < .05). Patients in group 2 seemed to have a higher incidence of nausea and vomiting both in the early (6 hours) and late postoperativ e (postoperative days 1 and 2) periods; however, the difference was no t statistically significant. Group 2 required less analgesic compared with groups 1 and 3 during the late postoperative period. Late postope rative activity and appetite were better in groups 2 and 3. Conclusion s. Because there was no significant difference in terms of postoperati ve analgesia in the retrobulbar block or subconjunctival local anesthe tic infiltration groups compared with the control group, we suggest th at conventional methods of pain treatment are adequate for postoperati ve analgesia in strabismus surgery.