The effect of sub-tenon lidocaine injection on pain and emergence agitation after strabismus surgery

Pediatric patients show various reactions during emergence from general anesthesia. Many cases of emergence agitation after anesthesia have been reported and pain was suggested as a major contributing factor. The purpose of this study was to evaluate the effect of sub-Tenon lidocaine injection on emergence agitation and pain in children after strabismus surgery.
In a randomized clinical trial, 40 children, aged 5-10 years, who were scheduled for strabismus surgery, were enrolled. Children were randomized two groups and at the end of surgery, the surgeon injected 1 ml of 2% lidocaine into the sub-Tenon space in study group and in control didn’t inject any drug. Pain and sedation were assessed in the post-anesthesia care unit using FACEs pain rating scale and Ramsay sedation scale respectively.
Patients in the sub-Tenon's lidocaine group had significantly lower pain scores in compare to control group (2.8±0.6 vs 4.6±1.7; p=0.0001). Ramsay sedation scores also were higher in sub-Tenon's lidocaine group (2.7±1.2 vs 1.2±0.4; p=0.0001)
In children undergoing strabismus surgery, sub-Tenon's block provides more effective analgesia and sedation.