Role of pterygopalatine blockade in the early rehabilitation program of children after congenital cataract surgery

Nowadays, the surgical treatment of congenital cataract is a “small-incisions” surgery (aspiration, in some cases — ultrasound phacoemulsification). It corresponds to the Fast Track surgery principles, and as a quick recovery technology it requires optimization of pain control in the early postoperative period.  

Purpose. To estimate the efficiency of the pterygopalatine block as a component of an optimized Fast Track protocol in children after congenital cataract surgery.

Materials and methods. 54 children operated for congenital cataract were included in the study. All patients were divided into 2 groups. In the first group (n = 26), a regional component of combined anesthesia on sevoflurane basis was carried out in combination with a pterygopalatine block; in the second group (n = 28), there was an implementation of a retrobulbar block. The efficiency of the methods was evaluated by a comparative analysis of hemodynamic parameters, the index of the vegetative system tension, the assessment of pain intensity by a verbal rating scale, as well as by the severity of ocular inflammatory reactions.

Results. Obtained data show that the pterygopalatine ganglion block as a component of a combined anesthesia in congenital cataract surgery allows providing adequate anesthesia, creating prolonged pain control, reducing the inflammatory reaction in postoperative period during the first 24 hours.

Conclusion. On the basis of our analysis, the possibility of a safe implementation of optimized (Fast-Track) protocol was proven.