Does Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery?
Robert W Arnold,1 Aleah N Bond2 1Pediatric Ophthalmology and Strabismus, Alaska Children’s EYE & Strabismus, Anchorage, AK 99508, USA; 2Department of Anesthesiology, Wake Forest Baptist Medical Center, Winston-Salem, NC 27101, USACorrespondence: Robert W ArnoldPediatric Ophthalmolo...
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Dove Medical Press
2019
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oai:doaj.org-article:e71fe93231b04d69802c77420523e4a52021-12-02T08:55:31ZDoes Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery?1177-5483https://doaj.org/article/e71fe93231b04d69802c77420523e4a52019-11-01T00:00:00Zhttps://www.dovepress.com/does-topical-proparacaine-improve-postoperative-comfort-after-strabism-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Robert W Arnold,1 Aleah N Bond2 1Pediatric Ophthalmology and Strabismus, Alaska Children’s EYE & Strabismus, Anchorage, AK 99508, USA; 2Department of Anesthesiology, Wake Forest Baptist Medical Center, Winston-Salem, NC 27101, USACorrespondence: Robert W ArnoldPediatric Ophthalmology and Strabismus, Alaska Children’s EYE & Strabismus Address 3500 Latouche #280, AK 99508 Tel +1 907561-1917Fax +1 907563-5373Email eyedoc@alaska.netBackground: Strabismus surgery is often performed on children and adults as a quick-turnover, outpatient procedure under general anesthesia. Ideal methods to reduce post-operative pain and nausea are not yet perfected. We postulated that a simple topical anesthetic drop after surgery might help.Methods: In a prospective study of oculocardiac reflex (OCR) and strabismus surgery, a cohort of ongoing patients either received proparacaine immediately post-op, or none. Co-variables were Intraoperative opioid and OCR, patient age, type of surgery. Several post-operative recovery outcome variables were prospectively monitored.Results: Sixty strabismus surgery patients (age 15±22 years) received proparacaine 1% while another 80 (16.5±22 years) received none; both received topical antibiotic-steroid ointment. Pain and nausea (Likert scale) were not impacted by covariables complexity of case, age less than 3.5, OCR >33% drop, intraoperative opioid or neuro-status. Immediate post-op heart rate was lower if OCR >33% and if opioids used. Time until discharge was shorter in younger patients. Proparacaine did not impact outcome variables, except in patients younger than 3.5 years when post-op pain was worse.Conclusion: Post-op topical anesthetic either produced no difference, or worsened post-op pain and recovery. This prospective study does not support the use of topical anesthetic drop to reduce post-strabismus pain and nausea.Clinical trials registration: NCT03672435, Strabismus Recovery With Proparacaine and Oculocardiac Reflex (OCRprop).Keywords: oculocardiac reflex, nausea and vomiting, anesthesia recovery, topical anestheticArnold RWBond ANDove Medical Pressarticleoculocardiac reflexnausea and vomitinganesthesia recoverytopical anestheticOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 2279-2283 (2019) |
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oculocardiac reflex nausea and vomiting anesthesia recovery topical anesthetic Ophthalmology RE1-994 Arnold RW Bond AN Does Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery? |
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Robert W Arnold,1 Aleah N Bond2 1Pediatric Ophthalmology and Strabismus, Alaska Children’s EYE & Strabismus, Anchorage, AK 99508, USA; 2Department of Anesthesiology, Wake Forest Baptist Medical Center, Winston-Salem, NC 27101, USACorrespondence: Robert W ArnoldPediatric Ophthalmology and Strabismus, Alaska Children’s EYE & Strabismus Address 3500 Latouche #280, AK 99508 Tel +1 907561-1917Fax +1 907563-5373Email eyedoc@alaska.netBackground: Strabismus surgery is often performed on children and adults as a quick-turnover, outpatient procedure under general anesthesia. Ideal methods to reduce post-operative pain and nausea are not yet perfected. We postulated that a simple topical anesthetic drop after surgery might help.Methods: In a prospective study of oculocardiac reflex (OCR) and strabismus surgery, a cohort of ongoing patients either received proparacaine immediately post-op, or none. Co-variables were Intraoperative opioid and OCR, patient age, type of surgery. Several post-operative recovery outcome variables were prospectively monitored.Results: Sixty strabismus surgery patients (age 15±22 years) received proparacaine 1% while another 80 (16.5±22 years) received none; both received topical antibiotic-steroid ointment. Pain and nausea (Likert scale) were not impacted by covariables complexity of case, age less than 3.5, OCR >33% drop, intraoperative opioid or neuro-status. Immediate post-op heart rate was lower if OCR >33% and if opioids used. Time until discharge was shorter in younger patients. Proparacaine did not impact outcome variables, except in patients younger than 3.5 years when post-op pain was worse.Conclusion: Post-op topical anesthetic either produced no difference, or worsened post-op pain and recovery. This prospective study does not support the use of topical anesthetic drop to reduce post-strabismus pain and nausea.Clinical trials registration: NCT03672435, Strabismus Recovery With Proparacaine and Oculocardiac Reflex (OCRprop).Keywords: oculocardiac reflex, nausea and vomiting, anesthesia recovery, topical anesthetic |
format |
article |
author |
Arnold RW Bond AN |
author_facet |
Arnold RW Bond AN |
author_sort |
Arnold RW |
title |
Does Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery? |
title_short |
Does Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery? |
title_full |
Does Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery? |
title_fullStr |
Does Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery? |
title_full_unstemmed |
Does Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery? |
title_sort |
does topical proparacaine improve postoperative comfort after strabismus surgery? |
publisher |
Dove Medical Press |
publishDate |
2019 |
url |
https://doaj.org/article/e71fe93231b04d69802c77420523e4a5 |
work_keys_str_mv |
AT arnoldrw doestopicalproparacaineimprovepostoperativecomfortafterstrabismussurgery AT bondan doestopicalproparacaineimprovepostoperativecomfortafterstrabismussurgery |
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