Ultrasound navigation during retrobulbar blockade in children with retinoblastoma and enucleation of the eyeball

Abstract

BACKGROUND: The retrobulbar block in children is used to enucleate analgesia in the intra- and postoperative period and prevent oculocardiac reflex (OCD), postoperative nausea, and vomiting. However, when the block is performed blindly, it results in serious complications. AIM: This study aimed to evaluate the efficacy and safety of a retrobulbar block performed under ultrasound guidance compared with a retrobulbar block performed blindly during enucleation of the eyeball in children with retinoblastoma. MATERIALS AND METHODS: A prospective randomized controlled trial was performed. The study included 40 patients who met the inclusion criteria. The patients were divided into two groups: 20 patients who underwent ultrasound-guided retrobulbar blockade (RBВ + ultrasound) and 20 patients who underwent blindly retrobulbar blockade (RBВ). RESULTS: There was an insignificant decrease in intraoperative opioid requirements in the RBB + ultrasound group, where the average dose of fentanyl was 41.4 g/kg, and in the RBB group, 4.70.8 g/kg (p 0.05). The time before the administration of the first dose of analgesic in the postoperative period was 4.70.8 h in the RBB group and 11.73.3 h in the RBB + ultrasound group (p 0.05). VAS and CHIPPS scores obtained 6 h after the end of surgery in the RBB + ultrasound and RBB groups were 1.8 (1.2; 2) and 2.5 (3.8; 4.5) points (p 0.05), respectively. CONCLUSION: There was no statistically significant difference between the time of the retrobulbar blockade under ultrasound guidance and the retrobulbar regional block performed blindly. Retrobulbar blockade performed under ultrasound guidance provides a decrease in intraoperative opioid requirements, stable intraoperative hemodynamics, and longer postoperative analgesia.