Divisione Oculistica, Ospedale San Pietro-Fatebenefratelli, Via Cassia 600, 00189, Rome, Italy.
Graefes Arch Clin Exp Ophthalmol. 2011 Oct;249(10):1511-4. doi: 10.1007/s00417-011-1803-9. Epub 2011 Aug 24.
Aim of the study was to investigate: 1) if second eye cataract surgery under topical anesthesia is more painful than surgery on the first eye, 2) if pain experienced during the procedure on the first eye may predict the pain of the second procedure, and 3) if patients' cooperation is different between the first and the second eye procedure.
Seventy-three consecutive patients undergoing bilateral non-simultaneous cataract surgery were prospectively included in the study. Surgical technique was sutureless clear corneal phacoemulsification under topical anesthesia. Immediately after surgery every patient graded the pain experienced using a visual analogue scale (VAS) from 0 (no pain) to 10 (unbearable pain). At the end of each procedure the surgeon graded patients' cooperation using a 4-point scale.
Mean VAS score was 2.35 (SD 2.63) for the first eye and 2.89 (SD 2.93) for the second eye. Such a difference was not statistically significant (p = 0.1777, Wilcoxon test). The correlation between the VAS score of the first and that of the second procedure was statistically significant (r = 0.5514, p < 0.0001, Spearman rank correlation). Patients' cooperation was 2.64 (SD 0.63) during the first procedure and 2.52 (SD 0.79) during the second procedure; this difference was not statistically significant (p = 0.1769, Wilcoxon matched-pairs signed-ranks test).
After uneventful cataract surgery under topical anesthesia, pain experienced and cooperation did not differ between first and second eye procedures. A correlation was found between pain scores of the first and the second eye procedures.
本研究旨在探讨:1)局部麻醉下第二只眼白内障手术是否比第一只眼手术更痛,2)第一只眼手术过程中的疼痛是否可预测第二只眼手术的疼痛,以及 3)患者在第一只眼和第二只眼手术中的配合是否不同。
73 例连续接受双侧非同期白内障手术的患者前瞻性纳入本研究。手术技术为无缝线透明角膜超声乳化术,局部麻醉。术后即刻,每位患者使用视觉模拟评分(VAS)从 0(无痛)到 10(无法忍受的疼痛)对所经历的疼痛进行分级。在每只眼手术结束时,外科医生使用 4 分制对患者的配合进行分级。
第一只眼的平均 VAS 评分为 2.35(SD 2.63),第二只眼为 2.89(SD 2.93)。这种差异无统计学意义(p=0.1777,Wilcoxon 检验)。第一只眼和第二只眼手术的 VAS 评分之间的相关性具有统计学意义(r=0.5514,p<0.0001,Spearman 等级相关)。第一只眼手术时患者的配合评分为 2.64(SD 0.63),第二只眼为 2.52(SD 0.79);这种差异无统计学意义(p=0.1769,Wilcoxon 配对符号秩检验)。
在局部麻醉下顺利进行白内障手术后,第一只眼和第二只眼手术过程中的疼痛和配合无差异。第一只眼和第二只眼手术的疼痛评分之间存在相关性。