Pediatric Ophthalmology.
MTI, Hayatabad Medical Complex, Peshawar-Pakistan.
J Ayub Med Coll Abbottabad. 2023 Feb-Mar;35(1):3-6. doi: 10.55519/JAMC-01-11512.
Strabismus is a common disease entity in paediatric age group usually requiring surgical intervention under general anaesthesia and Oculocardiac reflex is the most dangerous complications intraoperatively. Various anaesthetic options have been evaluated to mitigate this complication. The objective of this study was to assess the efficacy of sub-tenon's block in paediatric strabismus surgery in terms of reduction in oculocardiac reflex.
This prospective Randomized control trial was conducted at Department of ophthalmology, MTI, Hayatabad Medical complex, Peshawar over a period of six months from 1st July to 31st December 2021. A total of 124, were equally divided in subtenon's group (Group A) and placebo group (Group B). Intraoperatively, patients were assessed for Bradycardia and development of OCR. Data including demographics, intraoperative BP, HR and OCR development were noted and analysed with SPSS version 22.
The total number of patients were 124, 62 in each group with a mean age of 9.45±1.61. Sixty-six (53.22%) patients were males and 58 (46.87%) patients were females. At 10-, 20- and 30-minutes interval, the SBP and DBP has no significant difference. At 10, 20, 30 minutes interval, the HR differed significantly (79.33±7.36 vs 66.65±6.83 (p˂0.05), 79.78±7.63 vs 66.57±7.06 (p˂0.05), 79.80±7.78 vs 66.52±7.01 (p˂0.05), respectively. Intraoperative OCR was recorded in 13 (21%) patients in sub-tenon's (Group A) versus 56 (90.30%) patients in placebo (Group B) with statistically significant difference between the two (p<0.05).
Sub-tenon's injection of bupivacaine reduces the incidence of Bradycardia and OCR in squint surgery patients after general anaesthesia induction and usage is recommended in routine.
斜视是儿科常见疾病，通常需要全身麻醉下进行手术干预，眼心反射是术中最危险的并发症。已经评估了各种麻醉选择来减轻这种并发症。本研究的目的是评估在儿童斜视手术中使用前Tenon 阻滞在减少眼心反射方面的效果。
这是一项前瞻性随机对照试验，于 2021 年 7 月 1 日至 12 月 31 日在白沙瓦 Hayatabad 医疗综合体的 MTI 眼科进行。共有 124 名患者平均分为前 Tenon 组（A 组）和安慰剂组（B 组）。术中评估患者心动过缓和眼心反射的发生情况。记录并分析包括人口统计学、术中血压、心率和眼心反射发展在内的数据，使用 SPSS 版本 22 进行分析。
共有 124 名患者，每组 62 名，平均年龄为 9.45±1.61 岁。66 名（53.22%）患者为男性，58 名（46.87%）患者为女性。在 10 分钟、20 分钟和 30 分钟间隔，SBP 和 DBP 无显著差异。在 10、20、30 分钟间隔，HR 差异显著（79.33±7.36 vs 66.65±6.83（p˂0.05），79.78±7.63 vs 66.57±7.06（p˂0.05），79.80±7.78 vs 66.52±7.01（p˂0.05）。在前 Tenon 组（A 组）中有 13 名（21%）患者记录到术中眼心反射，而在安慰剂组（B 组）中有 56 名（90.30%）患者，两组之间存在统计学显著差异（p<0.05）。
在全身麻醉诱导后，前 Tenon 注射布比卡因可降低斜视手术患者心动过缓和眼心反射的发生率，建议常规使用。
