Ophthalmology Department, Hadassah Medical Center, Jerusalem, Israel.
Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel.
Int Ophthalmol. 2024 Sep 20;44(1):383. doi: 10.1007/s10792-024-03315-2.
To evaluate the correlation between the timing of instilling anesthetic eyedrops prior to intravitreal injection and the patient's perception of pain associated with the injection.
A prospective observational study which included 192 eyes of 192 patients. Time interval between instillation of Oxybuprocaine-0.4% and Tetracaine-0.5% eyedrops upon checking-in and injection was measured and pain level was evaluated by the 101-point-Numeric Rating Scale.
We found significant correlation between time interval from the first eyedrops to injection and injection related pain. The lowest pain score (11 ± 18) was found in the 11-15 min group, while the highest was found in the 0-6 min (26 ± 25) and in the > 35 min (31 ± 28) groups. The highest percentage of patients without pain was found in the 11-15 min (64%), followed by the 7-10 min (56%) and 16-20 min (47%) groups. 10% or 17% of the 0-6 min or > 35 min. groups, respectively, reported no pain. No patients in 11-15 min group reported severe pain versus 10% in the 0-6 min and 17% in the > 35 min groups. The highest percentage of patients with 'absent-to-mild' pain was in the 11-15 min (89%) and the 7-10 min (87%) compared to all other groups.
Administration of first dose of anesthetic eyedrops within 11-15 min before intravitreal injection yields the lowest levels of injection-related pain, with 7-10 min being second best. Administration of eyedrops outside of this time-window results in higher pain levels avoidable with more attention to the timing issue.
评估在玻璃体注药前滴麻醉眼药水的时间与患者对注射相关疼痛的感知之间的相关性。
本前瞻性观察研究共纳入 192 例 192 只眼的患者。记录从登记至注射时点滴布比卡因-0.4%和丁卡因-0.5%眼液的时间间隔，并采用 101 点数字评分量表评估疼痛程度。
我们发现从滴第一滴眼药水到注射的时间间隔与注射相关疼痛之间存在显著相关性。在 11-15 分钟组中疼痛评分最低（11±18），而在 0-6 分钟（26±25）和>35 分钟（31±28）组中疼痛评分最高。无疼痛患者比例最高的是 11-15 分钟组（64%），其次是 7-10 分钟组（56%）和 16-20 分钟组（47%）。0-6 分钟或>35 分钟组中，各有 10%或 17%的患者报告无疼痛。11-15 分钟组中无患者报告重度疼痛，而 0-6 分钟组中 10%的患者和>35 分钟组中 17%的患者报告重度疼痛。在 11-15 分钟组（89%）和 7-10 分钟组（87%）中，“无到轻度”疼痛的患者比例最高，而其他组的比例均较低。
在玻璃体注药前 11-15 分钟内滴注第一滴麻醉眼药水可产生最低的注射相关疼痛水平，7-10 分钟次之。如果不在此时间窗口内滴注眼药水，则会导致更高的疼痛水平，可通过更关注时间问题来避免。
