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Pain Relief for Strabismus Surgery in Children- a Randomised Controlled Study of the use of Preoperative Subtenon’s Levobupivacaine.
  1. Brid Morris (bridcmorris{at},
  2. patrick watts (patrick.watts{at},
  3. Tahsin Zatman,
  4. Michelle Absolom,
  5. Sajjad Haider,
  6. Judith Hall
  1. Princess Alexandra Eye Pavilion, United Kingdom
  2. University Hospital of Wales, United Kingdom
  3. University Hospital of Wales, United Kingdom
  4. University Hospital of Wales, United Kingdom
  5. University Hospital of Wales, United Kingdom
  6. University Hospital of Wales, United Kingdom


    Aims: To compare the postoperative pain scores in children undergoing squint surgery administered with preoperative subtenon’s 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 subtenon’s 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 minutes, 2, 4, 6 and 24 hours 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 subtenon’s 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 minutes, p=0.37 at 2 hours).

    Conclusions: Subtenon’s 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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