Efficacy of light-transmitting eye shields for wound dressing in preventing pediatric emergence agitation following bilateral strabismus surgeries: a randomized clinical trial.

BACKGROUND

Emergence agitation (EA) occurs in preschool children after ophthalmic surgery as eye shields induce visual disturbance. We aimed to investigate the efficacy of light-transmitting eye shields as an alternative to traditional medical gauze eye shields for wound dressing in terms of EA incidence following strabismus surgery.

METHODS

We randomly assigned 70 preschool children undergoing bilateral strabismus surgery to receive either light-transmitting (LT group, n = 35) or medical gauze (MG group, n = 35) eye shields upon the completion of surgery. The primary outcome was the difference in EA incidence between the groups.

RESULTS

After adjusting the data for age and sex, children in the LT group were less likely to develop EA than those in the MG group (5 of 35 children [14.3%] vs. 15 of 35 children [42.9%]; adjusted odds ratio: 0.28, 95% CI [0.08-0.94], P = 0.040). Compared with the MG group, a significant reduction in the median score of the peak Aono's four-point scale was observed in the LT group (P = 0.024; Benjamini-Hochberg [BH] critical value = 0.050). Additionally, the incidences of agitation (peak Pediatric Anesthesia Emergence Delirium score ≥ 16) and propofol administration in the LT group were significantly lower than those in the MG group (P = 0.022; BH critical value = 0.038 and P = 0.017; BH critical value = 0.025, respectively).

CONCLUSIONS

The application of light-transmitting eye shields for wound dressing could help prevent EA after pediatric bilateral strabismus surgery under sevoflurane anesthesia.