Paper 14

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Analgesic Eyedrops Reduce Opioid Demand after Strabismus Surgery

Jon Peiter Saunte, MD; Anette M. Hansen, RN; Lisbeth Balle Jensen, RN; Mette Stryhn Borger, RN;Tobias Torp-Pedersen, MD, PhD; Jonna Storm Fomsgaard, MD
Department of Ophthalmology,  Rigshospitalet, University of Copenhagen
Copenhagen, Denmark

Introduction:  Strabismus surgery may be associated with postoperative pain(1). We wanted to study if the need for intravenous (iv) sufentanil after strabismus surgery was influenced by addition of postoperative oxybuprocaine 0.4% eyedrops.

Methods:  All patients operated for strabismus during 4 months were included. During the first two months (controls, group A), standard pain treatment was: Preoperative paracetamol and peroperative ketoralac iv. In the PostAnesthesiaCareUnit (PACU), iv sufentanil (0,05-0,1mcg/kg) was added if needed. During the following two months (group B), additional oxybuprocaine eyedrops was given after surgery in the operating theater, and if needed, supplemented with iv sufentanil in the PACU. We registered the number of patients treated with iv sufentanil in the two groups. Results were analyzed in two-by-two contingency tables and evaluated with chi-squared test. We chose a 0.001 threshold for significance.

Results:  In group A(n=144), 53 were<18y, 91 were adults. In group B(n=109), 37 were<18y, 72 were adults. In the pediatric group, added oxybuprocaine eyedrops was associated with reduced need for postoperative sufentanil(24%, n=9), compared with controls(83%, n=44),p<0.001.|In the adult group, added oxybuprocaine eyedrops was associated with reduced need for post-operative treatment with sufentanil(3%, n=2), compared with controls(82%, n=75),p<0.001.|

Discussion:  Yousafzai(2) showed topical oxybuprocaine eyedrops after strabismus surgery reduces pain, nausea and vomiting compared with iv opioid analgesics. We found local analgesic eyedrops after strabismus surgery may reduce postoperative need for rescue iv sufentanil in both children and adults.

Conclusion:  Oxybuprocaine 0.4% eyedrops at surgery conclusion may reduce opioid demand after strabismus surgery.

References:  1. Wilson AC et al: Pain after discharge following head and neck surgery in children. Pediatr Anesth 26, 2016
2. Ibrahim Yousafzai, Abdul Zahoor, Butrov Andrey and Nauman Ahmad:
Comparison of topical oxybuprocaine and intravenous fentanyl in pediatric strabismus surgery. Saudi J Anaesth 2017 jan-mar;11(1):67-71

The data in this abstract was presented at The 10th Congress of the European Pain Federation, EFIC®, Copenhagen, Denmark, 6-9 September, 2017.

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