Modir Hesameddin, Moshiri Esmail, Amani Alireza, Modir Amirreza
Department of Anesthesiology, Faculty of Medicine Arak Medical University, Arak, Iran.
Department of Orthopedics, School of Medicine Iran University of Medical Sciences, Iran.
Oman J Ophthalmol. 2024 Oct 24;17(3):342-347. doi: 10.4103/ojo.ojo_246_23. eCollection 2024 Sep-Dec.
The aim of this study was to compare the sedative and analgesic effects of ketorolac and diclofenac eye drops among patients with cataract surgery (CS) who received tetracaine.
This double-blind randomized clinical trial was conducted in 2022. Participants were the candidates for CS consecutively selected from Amirkabir hospital, Arak, Iran, and were assigned to an artificial tear group, a ketorolac group, and a diclofenac group through block randomization. Pain, sedation status, heart rate, blood pressure, and arterial oxygen saturation were assessed during and after surgery. Complications prevalence and intraoperative propofol use were also documented. Data were analyzed using the SPSS software (v. 20.0) at a significance level of <0.05.
There were no significant differences among the study groups respecting participants' age, gender, body mass index, blood pressure, heart rate, arterial oxygen saturation, CS duration, and Aldrete score ( > 0.05). From 5 min after CS onward, the mean score of pain in the ketorolac group was significantly less than the other groups ( < 0.05). The mean score of sedation from recovery to 1 h after surgery in the artificial tear group was significantly more than the other groups, whereas the mean score of sedation 2 and 4 h after CS in the ketorolac group was significantly more than the other groups ( < 0.05). Propofol use in the artificial tear group was significantly more than in other groups ( = 0.001) and patient and surgeon satisfaction in this group was significantly less than in other groups ( < 0.05). The ketorolac and the diclofenac groups did not significantly differ from each other respecting surgeon and patient satisfaction and the prevalence of complications ( > 0.05).
Ketorolac eye drops are more effective than diclofenac eye drops in significantly reducing intraoperative pain among the candidates for CS with topical anesthesia. Therefore, ketorolac eye drops can be used with tetracaine eye drops in CS with topical anesthesia to produce greater perioperative analgesia and sedation.
本研究旨在比较酮咯酸和双氯芬酸滴眼液在接受丁卡因的白内障手术（CS）患者中的镇静和镇痛效果。
这项双盲随机临床试验于2022年进行。参与者是从伊朗阿拉克的阿米尔卡比尔医院连续挑选出的CS候选人，通过区组随机化被分配到人工泪液组、酮咯酸组和双氯芬酸组。在手术期间和术后评估疼痛、镇静状态、心率、血压和动脉血氧饱和度。还记录了并发症发生率和术中丙泊酚的使用情况。使用SPSS软件（v. 20.0）对数据进行分析，显著性水平<0.05。
在参与者的年龄、性别、体重指数、血压、心率、动脉血氧饱和度、CS持续时间和Aldrete评分方面，研究组之间没有显著差异（>0.05）。从CS后5分钟起，酮咯酸组的平均疼痛评分显著低于其他组（<0.05）。人工泪液组从恢复到术后1小时的平均镇静评分显著高于其他组，而酮咯酸组在CS后2小时和4小时的平均镇静评分显著高于其他组（<0.05）。人工泪液组丙泊酚的使用显著多于其他组（=0.001），该组患者和外科医生的满意度显著低于其他组（<0.05）。在外科医生和患者满意度以及并发症发生率方面，酮咯酸组和双氯芬酸组之间没有显著差异（>0.05）。
在局部麻醉的CS候选人中，酮咯酸滴眼液在显著减轻术中疼痛方面比双氯芬酸滴眼液更有效。因此，在局部麻醉的CS中，酮咯酸滴眼液可与丁卡因滴眼液联合使用，以产生更好的围手术期镇痛和镇静效果。
