Comparison of sub-Tenon's block with i.v. fentanyl for paediatric vitreoretinal surgery.
Br J Anaesth
; 103(5): 739-43, 2009 Nov.
Article
en En
| MEDLINE
| ID: mdl-19706631
ABSTRACT
BACKGROUND:
Vitreoretinal (VR) surgery is associated with moderate to severe pain and significant postoperative nausea and vomiting (PONV). The study aimed to assess the effectiveness of sub-Tenon's block for providing perioperative analgesia in children undergoing VR surgery.METHODS:
In a randomized, observer-blinded trial, after obtaining institutional ethical committee approval and parental consent, 200 ASA grade I-II children aged 5-16 yr were allocated to receive either a sub-Tenon's block (Group SB) or 2 microg kg(-1) i.v. fentanyl (Group F) after induction of anaesthesia and topical anaesthesia of the conjunctiva with proparacaine 0.5% drops. Patients in Group F received fentanyl 0.5 microg kg(-1) and those in Group SB were given a corresponding volume of normal saline i.v. every hour from preloaded syringes. Increases in heart rate or mean arterial pressure by more than 20% of baseline were treated with additional 0.5 microg kg(-1) i.v. fentanyl boluses in both groups. The incidence of oculocardiac reflex (OCR), need for additional analgesics, postoperative pain, and PONV were recorded for the first 24 h after surgery.RESULTS:
More patients in Group F (47.96%) had moderate to severe pain in the first 24 h when compared with Group SB (31.36%) (P=0.023). The need for postoperative ibuprofen was higher in Group F (66.3%) compared with Group SB (47.95%) (P=0.012). The incidence of OCR was significantly higher in Group F (31.6%) compared with Group SB (5.1%) (P<0.001). The incidence of PONV was similar in both groups.CONCLUSIONS:
Sub-Tenon's block provides more effective analgesia than i.v. fentanyl for paediatric VR surgery.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Procedimientos Quirúrgicos Oftalmológicos
/
Fentanilo
/
Analgésicos Opioides
/
Bloqueo Nervioso
Tipo de estudio:
Clinical_trials
/
Etiology_studies
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Idioma:
En
Año:
2009
Tipo del documento:
Article