Myopexy (Faden) results in more postoperative vomiting after strabismus surgery in children

Background: Strabismus correction in children is associated with a high inc idence of postoperative nausea and vomiting. The purpose of this prospectiv e, double-blind study was to examine the influence of the surgical method f or correction of squint on the incidence of postoperative vomiting. Methods: One hundred and twenty consecutive children aged 2-12 years, sched uled for elective strabismus surgery, were enrolled in this prospective, do uble-blind study. A standardised total intravenous anaesthesia was given to all children. The development of perioperative oculocardiac reflex was not ed and the number of episodes of vomiting during the first 48 h postoperati vely was recorded. At the completion of the study, the children who were op erated with myopexy according to Faden, were allocated to a Faden group, th ose without a myopexy to the non-Faden group. All the patients included in this study were operated on by the same surgeon with standardised technique s. Results: The Faden group was younger, lighter and the operation time was lo nger (P<0.05). The incidence of vomiting was greater in the Faden group; 53 % versus 12% (P<0.05). The incidence of oculocardiac reflex was similar in both groups; 40% in the Faden versus 28% in the non-Faden group, respective ly. The total dose of propofol and alfentanil was similar between the group s. Requirement of analgesics for postoperative pain was similar in both gro ups. The only independent risk factor for postoperative vomiting was the Fa den operation. Conclusion: The surgical method used for strabismus correction in children has a great influence on the incidence of postoperative vomiting. The Faden operation is associated with a very high incidence of postoperative vomiti ng; this particular group of patients has to be considered as a high risk g roup for postoperative vomiting and deserves an antiemetic prophylaxis.