Monitored care during anesthesia with remifentanil and lidocaine in pediatric strabismus surgery: A single-center experience

Purpose: To evaluate the use of monitored anesthesia care (MAC) in pediatric strabismus surgery. Methods: A total of 17 cases undergoing strabismus surgery with MAC were included in this study. The protocol for sedation was standardized and data were collected prospectively for an ongoing quality assurance project. Intravenous channels were established in the ward for all the children, and penehyclidine 0.01 mg/kg and ondansetron 0.1 mg/kg were injected intravenously. After communicating with children the second time, 0.05 mg/kg midazolam, 0.1 mu g/kg sufentanil, and 2 mg/kg propofol were injected intravenously. Continuous intravenous pumping of remifentanil 0.1 similar to 0.2 mu g/kg/min while local infiltration anesthesia was performed with 1 % lidocaine after the loss of consciousness. Results: It took 7.0 +/- 3.5 min to wake up successfully. There was no nausea, vomiting, or delirium after the operation. The children had good postoperative recovery and no bad memories, and they and their families were highly satisfied with the surgery. Conclusion: Local anesthesia and MAC produces satisfactory sedation in most patients without switching to general anesthesia. However, it has to be fully demonstrated that MAC local anesthesia is superior to general anesthesia in pediatric strabismus surgery via multi-centered studies.