İnaltekin Ali, Bozkurt Erdinç, Kıvrak Yüksel
Department of Psychiatry, Oltu State Hospital, Erzurum, Turkey.
Department of Ophthalmology, Umraniye Training and Research Hospital, İstanbul, Turkey.
J Curr Ophthalmol. 2021 Oct 22;33(3):323-329. doi: 10.4103/joco.joco_6_21. eCollection 2021 Jul-Sep.
To identify the factors associated with the pain level in patients receiving intravitreal injection.
A total of 120 patients were prospectively evaluated, and 104 were included in the study. Patients were asked to rate their pain intensity from 0 to 10 on the visual analog scale. Factors that were possibly associated with pain level were evaluated using a sociodemographic data form, state anxiety inventory, and the hospital anxiety and depression scale.
Of the participants, 54 (51.9%) were female, and 50 (48.1%) were male, with a mean age of 65 ± 9.01 years. There was a positive correlation between pain level and state anxiety scores ( = 0.30; < 0.001) and a negative correlation between hospital anxiety score ( = -0.23; = 0.02) and hospital depression score ( = -0.27; = 0.01). The correlation between pain score and education level was significantly higher in primary and secondary school graduates ( < 0.01). Smokers were observed to have higher pain scores (6.50 ± 2.21 in smokers and 4.87 ± 2.50 in nonsmokers; = 0.01). Among diagnostic groups, pain scores were found to be significantly lower in the diabetic retinopathy (DR) group (6.82 ± 1.99 in age-related macular degeneration, 5.94 ± 2.27 in retinal vein occlusion, and 3.58 ± 1.97 in DR; < 0.001). When pain scores were evaluated according to the drug injected, the group receiving bevacizumab injection was observed to have higher pain scores (7.32 ± 1.81 in bevacizumab, 4.00 ± 2.08 in aflibercept, and 3.92 ± 1.96 in ranibizumab; < 0.001). Based on the multiple regression analysis, the state anxiety score, hospital anxiety score, hospital depression score, and smoking status were observed not to be significant predictors. The level of education, diagnosis, and active substance were found to have a statistically significant effect on pain perception.
In this study, pain levels have been found to be high in smokers, those with a low educational level, individuals receiving bevacizumab for intravitreal injection, and those having a higher level of state anxiety, whereas patients with DR have lower pain scores.
确定与接受玻璃体内注射患者疼痛程度相关的因素。
前瞻性评估了总共120例患者，其中104例纳入研究。要求患者使用视觉模拟量表从0至10对其疼痛强度进行评分。使用社会人口统计学数据表格、状态焦虑量表以及医院焦虑抑郁量表评估可能与疼痛程度相关的因素。
参与者中，54例（51.9%）为女性，50例（48.1%）为男性，平均年龄为65±9.01岁。疼痛程度与状态焦虑评分之间存在正相关（r = 0.30；P < 0.001），医院焦虑评分（r = -0.23；P = 0.02）和医院抑郁评分（r = -0.27；P = 0.01）之间存在负相关。小学和中学毕业生的疼痛评分与教育水平之间的相关性显著更高（P < 0.01）。观察到吸烟者的疼痛评分更高（吸烟者为6.50±2.21，非吸烟者为4.87±2.50；P = 0.01）。在诊断组中，发现糖尿病视网膜病变（DR）组的疼痛评分显著更低（年龄相关性黄斑变性组为6.82±1.99，视网膜静脉阻塞组为5.94±2.27，DR组为3.58±1.97；P < 0.001）。根据注射药物评估疼痛评分时，观察到接受贝伐单抗注射的组疼痛评分更高（贝伐单抗组为7.32±1.81，阿柏西普组为4.00±2.08，雷珠单抗组为3.92±1.96；P < 0.001）。基于多元回归分析，状态焦虑评分、医院焦虑评分、医院抑郁评分和吸烟状况未被观察到是显著的预测因素。教育水平、诊断和活性物质被发现对疼痛感知有统计学上的显著影响。
在本研究中，发现吸烟者、教育水平低者、接受玻璃体内注射贝伐单抗者以及状态焦虑水平较高者的疼痛程度较高，而DR患者的疼痛评分较低。
