Contact topical anesthesia for strabismus surgery in adult patients

Objective: To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. Material and methods: A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed. Results: The operation was performed successfully in all patients. Average pain intensity was 1.40 +/- 1.73 during anesthesia implementation, 4.20 +/- 2.57 during the surgical procedure, 2.50 +/- 2.54 30 min after surgery, and 3.55 +/- 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 +/- 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters. Conclusions: Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment. (C) 2014 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor. Published by Elsevier Espana, S.L.U. All rights reserved.