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比较在接受择期玻璃体手术时行眼周麻醉与行球后麻醉的患者的疼痛体验。

COMPARISON OF PAIN EXPERIENCE IN PATIENTS UNDERGOING SUB-TENON'S ANESTHESIA VERSUS PERIBULBAR ANESTHESIA DURING ELECTIVE VITREORETINAL SURGERY.

机构信息

Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy.

Ophthalmology Unit, Catholic University "Sacro Cuore", Rome, Italy.

出版信息

Retina. 2022 Oct 1;42(10):1852-1858. doi: 10.1097/IAE.0000000000003566.

DOI:10.1097/IAE.0000000000003566
PMID:35976228
Abstract

PURPOSE

To assess and compare the patients' discomfort and pain experienced during anesthesia, pars plana vitrectomy, and 24 hours postoperatively after sub-Tenon's injection (STI) versus peribulbar block (PB) in elective vitreoretinal surgery.

METHODS

Retrospective study involving 80 patients who underwent elective vitreoretinal surgery receiving either PB (Group 1, n = 40) or STI (Group 2, n= 40) between January 2021 and March 2022. Patients' pain experienced during the procedure and 24 hours postoperatively were assessed using a pain scale and a two-section questionnaire. One hour postoperatively, patients were asked to rate the level of pain they felt during the entire procedure by pointing at a 0 to 100 Visual Analog Scale. Subsequently, patients answered a two-section questionnaire regarding pain and discomfort felt 24 hours postoperatively.

RESULTS

According to Visual Analog Scale measurements, patients experienced significantly more pain during PB than during STI 1 hour after surgery. Patients undergoing PB experienced more pain than those who underwent STI, experiencing burning and discharge feeling. Patients undergoing STI had a lower pain level score 24 hours postoperatively despite similar discomfort.

CONCLUSION

Sub-Tenon's injection has a lower pain score than PB during the procedure and 24 hours postoperatively, representing a valuable procedure to deliver analgesia in vitreoretinal surgery.

摘要

目的

评估和比较经睫状体平坦部玻璃体切除术(PPV)和术后 24 小时行球周(PB)或Tenon 下注射(STI)麻醉时患者的不适和疼痛。

方法

回顾性研究纳入 2021 年 1 月至 2022 年 3 月间行选择性玻璃体视网膜手术的 80 例患者,接受 PB(组 1,n = 40)或 STI(组 2,n = 40)。使用疼痛量表和两段式问卷评估患者在手术过程中和术后 24 小时的疼痛。术后 1 小时,患者通过在 0 到 100 的视觉模拟量表上指出他们在整个手术过程中感到的疼痛程度来评分。随后,患者回答了关于术后 24 小时疼痛和不适的两段式问卷。

结果

根据视觉模拟量表测量,患者在 PB 后 1 小时比在 STI 后感到更明显的疼痛。接受 PB 的患者比接受 STI 的患者感到更强烈的疼痛,有烧灼感和分泌物感。接受 STI 的患者在术后 24 小时的疼痛评分较低,但不适感相似。

结论

与 PB 相比,STI 在手术过程中和术后 24 小时的疼痛评分较低,是玻璃体视网膜手术中提供镇痛的有价值的方法。

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