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Pain relief for strabismus surgery in children: a randomised controlled study of the use of preoperative sub-Tenon levobupivacaine
  1. B Morris1,
  2. P Watts1,
  3. T Zatman2,
  4. M Absolom2,
  5. S Haider1,
  6. J Hall2
  1. 1
    Department of Ophthalmology, University Hospital of Wales, Cardiff, UK
  2. 2
    Department of Anaesthesia, University Hospital of Wales, Cardiff, UK
  1. Mr P Watts, Department of Ophthalmology, University Hospital of Wales, Cardiff CF14 4XW, UK; patrick.watts{at}


Aims: To compare the postoperative pain scores in children undergoing squint surgery administered with preoperative sub-Tenon levobupivacaine for postoperative pain relief versus controls.

Methods: A prospective randomised controlled clinical trial was performed. Children aged 1–16 years undergoing strabismus surgery were recruited. The test group received sub-Tenon levobupivacaine preoperatively and topical anaesthetic eye-drops at the end of the procedure. The control group received topical anaesthetic eye-drops only at the end of surgery. Pain scores were recorded at 30 min, 2, 4, 6 and 24 h postoperatively using the Wong–Baker Pain or FLACC (face, legs, arms, cry, consolability) assessment score. The principal outcome measured was the pain score at each time interval for both groups.

Results: 27 patients received sub-Tenon levobupivacaine, and there were 27 age- and sex-matched controls. The pain score in the test group was not lower than that of the control group (p = 0.22 at 30 min, p = 0.37 at 2 h).

Conclusions: Sub-Tenon levobupivacaine, which is widely used for postoperative pain relief in paediatric strabismus surgery, was not effective when administered preoperatively in this cohort.

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  • Competing interests: None.

  • Patient consent: Ethics approval was provided by the Local Research and Ethics Board, Bro Taf Health Authority, Wales, UK.

  • Patient consent: Obtained from the parents.

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