Department of Ophthalmology, Lincoln County Hospital, Lincoln, UK.
Ophthalmology. 2010 Sep;117(9):1810-4. doi: 10.1016/j.ophtha.2010.01.036. Epub 2010 Jun 8.
The aim of the study was to determine whether subconjunctival anesthesia is effective at reducing pain associated with laser retinopexy.
This was a single-center, prospective, patient-masked, randomized, controlled trial.
In the primary study group, 65 patients were recruited. Thirty-two patients (32 eyes) received anesthetic injection, and 33 patients (33 eyes) received the sham injection. The crossover study group consisted of 28 patients (56 eyes).
Between February 2008 and April 2008, all patients who were consecutively booked to undergo panretinal photocoagulation (PRP) or peripheral laser retinopexy (PLR) were invited to participate in the study. Patients were randomized to receive subconjunctival lidocaine injection or a sham injection before their intended laser retinal treatment. These patients were defined as our primary study group. Patients who required a second laser treatment received the opposite injection in a masked fashion before laser retinal treatment. These patients were defined as our crossover group. Patients in both the primary study group and the crossover group were masked to the treatment given. After the laser treatment, patients completed a pain questionnaire.
The primary outcome was incidence of pain. The secondary outcome was severity of pain.
Primary study group: In the anesthetic treatment group, 19 patients (59%) experienced pain compared with 32 patients (97%) in the sham treatment group (P<0.001). Among the patients who did experience pain, the average pain score was 3.6 in the anesthetic treatment group and 4.1 in the sham treatment group (P=0.55). Crossover study group: In the anesthetic treatment group, 12 patients (43%) experienced pain compared with 28 patients (100%) in the sham treatment group (P<0.001). In patients who did experience pain, the average pain score was 3.3 in the anesthetic treatment group and 4.6 in the sham treatment group. Twenty patients (71%) preferred anesthetic to sham treatments, 1 patient (4%) preferred sham over anesthetic, and 7 patients (25%) thought both laser treatments were the same.
Subconjunctival 2% lidocaine significantly reduces the incidence of pain in patients who receive PRP or PLR.
本研究旨在确定球结膜下麻醉是否能有效减轻激光视网膜固定术相关疼痛。
这是一项单中心、前瞻性、患者设盲、随机、对照试验。
在主要研究组中，招募了 65 名患者。32 名患者（32 只眼）接受了麻醉注射，33 名患者（33 只眼）接受了假注射。交叉研究组由 28 名患者（56 只眼）组成。
在 2008 年 2 月至 4 月期间，连续预约行全视网膜光凝术（PRP）或周边激光视网膜固定术（PLR）的所有患者均被邀请参与研究。患者被随机分配接受球结膜下利多卡因注射或假注射，然后再进行预期的激光视网膜治疗。这些患者被定义为我们的主要研究组。需要进行第二次激光治疗的患者在接受激光视网膜治疗前以设盲方式接受相反的注射。这些患者被定义为我们的交叉组。主要研究组和交叉组的患者均对所给予的治疗进行设盲。激光治疗后，患者完成疼痛问卷。
主要结局为疼痛发生率。次要结局为疼痛严重程度。
主要研究组：在麻醉治疗组中，19 名患者（59%）出现疼痛，而在假治疗组中，32 名患者（97%）出现疼痛（P<0.001）。在出现疼痛的患者中，麻醉治疗组的平均疼痛评分为 3.6，假治疗组的平均疼痛评分为 4.1（P=0.55）。交叉研究组：在麻醉治疗组中，12 名患者（43%）出现疼痛，而在假治疗组中，28 名患者（100%）出现疼痛（P<0.001）。在出现疼痛的患者中，麻醉治疗组的平均疼痛评分为 3.3，假治疗组的平均疼痛评分为 4.6。20 名患者（71%）更喜欢麻醉治疗，1 名患者（4%）更喜欢假治疗，7 名患者（25%）认为两种激光治疗相同。
球结膜下 2%利多卡因可显著降低接受 PRP 或 PLR 治疗的患者疼痛发生率。
