Anaesthesia for paediatric eye surgery

Davies, Ian D.M.; Sale, Steven

doi:10.1016/j.mpaic.2013.11.004

Cited by 1 publication

(5 citation statements)

References 2 publications

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“…Our results further confirmed the finding that clonidine premedication at 4 µg/kg provided a reduction in the need for additional analgesia by 39% in children undergoing ophthalmic surgery specifically. Ophthalmic surgeries such as squint, evisceration, and vitreoretinal surgery are associated with increased severity of pain . Besides, we found that children receiving clonidine premedication experienced lower pain intensities, and more reported being pain‐free.…”

Section: Discussionmentioning

confidence: 71%

“…Ophthalmic surgeries such as squint, evisceration, and vitreoretinal surgery are associated with increased severity of pain. 3,4 Besides, we found that children receiving clonidine premedication experienced lower pain intensities, and more reported being painfree. Therefore, clonidine premedication is also an effective clinical strategy to prevent postoperative pain in children undergoing ophthalmic surgery.…”

Section: Strengths and Weaknesses Concerning Other Studiesmentioning

confidence: 75%

“…Postoperative pain is a common complaint of patients and remains a significant clinical problem. Previous studies demonstrated that the treatment of postoperative pain in children is inadequate . The main reasons are difficulties with pain assessment and concerns related to side effects of opioid analgesics in children.…”

Section: Discussionmentioning

confidence: 99%

“…Pediatric patients undergoing ophthalmologic surgery are particularly likely to experience emesis. In a subset of patients receiving intraocular surgery or strabismus surgery, the POV rate can be as high as 90% or 76%, respectively . Moreover, most ophthalmic surgical procedures also result in mild‐to‐moderate postoperative pain, which may be associated with POV with children if left untreated.…”

Section: Introductionmentioning

confidence: 99%

“…In a subset of patients receiving intraocular surgery or strabismus surgery, the POV rate can be as high as 90% or 76%, respectively. 3,4 Moreover, most ophthalmic surgical procedures also result in mild-to-moderate postoperative pain, which may be associated with POV with children if left untreated. Considering the high incidence of POV in pediatric ophthalmic surgery, the use of antiemetic prophylaxis instead of therapy is warranted.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of clonidine on postoperative vomiting and pain in pediatric ophthalmic surgery: A systematic review and meta‐analysis

Hsu

Chu

Bai

et al. 2019

Pediatric Anesthesia

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Background Postoperative vomiting and pain are common, unpleasant phenomena in pediatric patients undergoing ophthalmic surgery. Clonidine has antiemetic and analgesic properties and thus may be used as premedication to reduce postoperative vomiting and pain. Aim To assess whether clonidine premedication may safely decrease postoperative vomiting and postoperative pain in pediatric patients who received an ophthalmic surgery. Methods We systematically searched PubMed, EMBASE, Cochrane Library, and Scopus databases from their inception to September 2018. Randomized clinical trials comparing clonidine premedication with a placebo or an active comparator that investigated postoperative vomiting or postoperative pain in pediatric patients undergoing ophthalmic surgery were included. The primary outcome was postoperative vomiting. The secondary outcome was postoperative pain. We also evaluated the safety of clonidine premedication by tracking hemodynamic instability associated with its use. Results Ten studies with 979 patients were eligible for inclusion. Clonidine achieved a significantly lower incidence of postoperative vomiting within 6 hours postoperatively, 6‐24 hours postoperatively, and at the end of the study (risk difference: −0.15; 95% confidence interval: −0.32 to −0.05; risk difference: −0.15; 95% confidence interval: −0.29 to 0.01; and risk difference: −0.23; 95% confidence interval: −0.34 to −0.12, respectively) than placebo. For the subgroup of patients who received strabismus surgery, clonidine produced a lower incidence of postoperative vomiting than placebo (risk difference: −0.19; 95% confidence interval: −0.29 to −0.05). Compared to benzodiazepine, clonidine achieved a lower incidence of postoperative vomiting at the end of the study (risk difference: −0.19; 95% confidence interval: −0.31 to −0.07); the effect was only observed in patients receiving clonidine 4 μg/kg. Furthermore, children receiving clonidine had lower postoperative pain scores, lower analgesic requirements, and more of them were pain‐free compared to those who received a placebo. No patient using clonidine had any major hemodynamic instability. Conclusion Compared to placebo or benzodiazepine, clonidine premedication was effective in reducing postoperative vomiting in pediatric patients undergoing ophthalmic surgery. Clonidine premedication also provided more reduction in postoperative pain when compared to placebo. The use of clonidine premedication was not associated with adverse hemodynamic events.

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Section: Discussionmentioning

confidence: 71%

Section: Strengths and Weaknesses Concerning Other Studiesmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations