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经鼻蝶腭神经节阻滞用于糖尿病视网膜病变全视网膜光凝激光治疗中的疼痛缓解:一项干预前后研究。

Transnasal sphenopalatine ganglion block for pain relief during panretinal photocoagulation laser for diabetic retinopathy: a pre and post interventional study.

机构信息

Pain Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Department of Anesthesiology and Critical Care, Imam Khomeini Medical Center, Tehran university of medical science, Tehran, Iran.

出版信息

Sci Rep. 2022 Jun 29;12(1):10964. doi: 10.1038/s41598-022-14745-2.

Abstract

This study was performed to utilize transnasal Sphenopalatine Ganglion (SPG) block for pain reliving during panretinal photocoagulation (PRP) in diabetic patients with diabetic retinopathy. This pre and post interventional study was performed on 20 patients with proliferative diabetic retinopathy. The first PRP treatment session of all the patients is performed with no transnasal SPG block, but before holding the second session, all the patients underwent transnasal SPG block and pain levels during and after PRP were compared to each other. Before the transnasal SPG block, each nostril of all the cases was inspected for finding any obstruction in each PRP session. Transnasal SPG block was also performed in with 2% lidocaine. The mean age of the included cases was 52.84 ± 8.62 years old (from 36 to 72 years old). All the cases underwent two PRP lasers treatment sessions with the same characteristic (spot size, power and duration) for each patient. In the first and second PRP treatment sessions, the mean NRS scores were obtained immediately after the PRP laser (8.4 vs. 4.2), 15 min (8.2 vs. 4.2), 1 h (8.0 vs. 4.1), and 24 h (5.4 vs. 3.6) after the PRP respectively. The mean NRS scores significantly reduced during the second PRP treatment session compared to the first session (p < 0.001). Transnasal SPG block is a safe and effective strategy used for relieving pain caused by the PRP laser treatment in patients with diabetic retinopathy.

摘要

本研究旨在利用经鼻蝶腭神经节(SPG)阻滞缓解糖尿病性视网膜病变患者行全视网膜光凝(PRP)时的疼痛。这项前瞻性干预研究纳入了 20 例增殖性糖尿病性视网膜病变患者。所有患者的首次 PRP 治疗均未行经鼻 SPG 阻滞,但在进行第二次治疗前,所有患者均接受了经鼻 SPG 阻滞,并比较了 PRP 过程中和之后的疼痛程度。在进行经鼻 SPG 阻滞之前,检查了所有患者的每侧鼻腔,以发现每次 PRP 治疗中是否存在任何阻塞。经鼻 SPG 阻滞采用 2%利多卡因进行。纳入病例的平均年龄为 52.84 ± 8.62 岁(36-72 岁)。所有患者均接受了两次具有相同特征(光斑大小、功率和持续时间)的 PRP 激光治疗。在第一次和第二次 PRP 治疗中,PRP 激光后即刻(8.4 对 4.2)、15 分钟(8.2 对 4.2)、1 小时(8.0 对 4.1)和 24 小时(5.4 对 3.6)的平均 NRS 评分分别为 8.4 对 4.2。与第一次治疗相比,第二次治疗的平均 NRS 评分显著降低(p<0.001)。经鼻 SPG 阻滞是一种安全有效的策略,可缓解糖尿病性视网膜病变患者行 PRP 激光治疗时引起的疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa0e/9243058/dd14822243b0/41598_2022_14745_Fig1_HTML.jpg

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