Efficacy of subtenon block in infants - a comparison with intravenous fentanyl for perioperative analgesia in infantile cataract surgery.
BACKGROUND
General anesthesia with opioids provides good perioperative analgesia in infantile ocular surgeries but is associated with the risk of respiratory depression and postoperative emesis. This study aimed to assess the effectiveness of subtenon block for providing perioperative analgesia in infants undergoing cataract surgeries.


METHODS
In this prospective, randomized, controlled, double-blinded trial, 63 infants of ASA grade I and II (1-12 months) were recruited to receive either subtenon block (Group SB) or 1 μg·kg(-1) i.v. fentanyl (Group F) after induction of anesthesia. Primary outcome was the number of infants requiring rescue analgesia during 4-h study period before discharge of the infants. Secondary outcomes assessed were CRIES pain score, incidence of oculocardiac reflex, surgical difficulty, and incidence of postoperative emesis.


RESULTS
The number of infants requiring rescue analgesia during 4-h study period was significantly less in Group SB (n = 6/32, 18.8%) compared to Group F (n = 14/31, 45.2%, P = 0.032). CRIES scores were significantly lower at and after 40 min compared to immediate postoperative period in Group F while these were comparable at all time intervals in Group SB. CRIES scores were significantly lower in Group SB compared to Group F at all time intervals except at 1 h. The incidence of oculocardiac reflex and the postoperative emesis were comparable in both the groups.


CONCLUSION
Subtenon block is an effective superior technique for postoperative analgesia compared to intravenous fentanyl in infants undergoing cataract surgery.
['Sethi|Sameer|S|', 'Ghai|Babita|B|', 'Sen|Indu|I|', 'Ram|Jagat|J|', 'Wig|Jyotsna|J|']
D000698:Analgesia D000701:Analgesics, Opioid D001784:Blood Gas Analysis D002387:Cataract Extraction D004311:Double-Blind Method D005260:Female D005283:Fentanyl D006801:Humans D007223:Infant D007431:Intraoperative Complications D053208:Kaplan-Meier Estimate D017214:Laryngeal Masks D008297:Male D016343:Monitoring, Intraoperative D009407:Nerve Block D010147:Pain Measurement D010149:Pain, Postoperative D019990:Perioperative Care D020250:Postoperative Nausea and Vomiting D012024:Reflex, Oculocardiac D018401:Sample Size D016019:Survival Analysis D016896:Treatment Outcome
subtenon block infants fentanyl analgesia cataract surgery