Sukkee Janrapee, Taechajongjintana Natnaree, Ratanawongphaibul Kitiya, Itthipanichpong Rath, Manassakorn Anita, Tantisevi Visanee, Rojanapongpun Prin, Chansangpetch Sunee
Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
Center of Excellence in Glaucoma, Chulalongkorn University, Bangkok 10330, Thailand.
J Clin Med. 2023 Mar 31;12(7):2634. doi: 10.3390/jcm12072634.
This study aimed to assess the pain experienced during micropulse transscleral laser therapy (MPTLT) and overnight thereafter and explore the factors associated with the pain.
This prospective study included 100 eyes of 81 glaucoma patients undergoing MPTLT under retrobulbar anesthesia. All patients were asked to rate both types of pain using a numerical rating scale (NRS). The risk factors were explored using multivariable mixed-effects ordinal logistic regression.
The mean (SD) NRS pain score during the procedure was 3.57 (3.41) (range 0-10), which included no, mild, moderate, and severe pain in 30 (30%), 33 (33%), 17 (17%), and 20 (20%) eyes, respectively. The mean (SD) NRS score of overnight pain was 2.99 (2.28) (range 0-9), which included no, mild, moderate, and severe pain in 17 (17%), 59 (59%), 17 (17%), and 7 (7%) eyes, respectively. Twenty-seven (27%) eyes reported worse pain overnight than during the procedure. Increased age, initial intraocular pressure, and pain during the procedure were significantly associated with increased overnight pain ( < 0.05).
Up to a fourth of eyes had worse pain after discharge. Older age, initial intraocular pressure, and pain during the procedure were risk factors for higher levels of overnight pain.
本研究旨在评估微脉冲经巩膜激光治疗（MPTLT）期间及之后过夜时所经历的疼痛，并探讨与疼痛相关的因素。
这项前瞻性研究纳入了81例接受球后麻醉下MPTLT的青光眼患者的100只眼睛。所有患者均被要求使用数字评分量表（NRS）对两种类型的疼痛进行评分。使用多变量混合效应有序逻辑回归分析危险因素。
手术过程中的平均（标准差）NRS疼痛评分为3.57（3.41）（范围0 - 10），其中30只眼（30%）无疼痛、33只眼（33%）轻度疼痛、17只眼（17%）中度疼痛、20只眼（20%）重度疼痛。过夜疼痛的平均（标准差）NRS评分为2.99（2.28）（范围0 - 9），其中17只眼（17%）无疼痛、59只眼（59%）轻度疼痛、17只眼（17%）中度疼痛、7只眼（7%）重度疼痛。27只眼（27%）报告过夜时疼痛比手术期间更严重。年龄增加、初始眼压以及手术期间的疼痛与过夜疼痛增加显著相关（<0.05）。
多达四分之一的眼睛在出院后疼痛加剧。年龄较大、初始眼压以及手术期间的疼痛是过夜疼痛程度较高的危险因素。
