Zheng De-Zhi, Chen Wei-Qi, Huang Zi-Jing, Huang Ding-Guo, Lin Pei-Min
Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, 69 North Dongxia Road, Jinping District, Shantou, 515041, Guangdong, People's Republic of China.
Int Ophthalmol. 2025 Aug 28;45(1):359. doi: 10.1007/s10792-025-03734-9.
This study aimed to evaluate the feasibility of real-time intraoperative pain assessment using a digital force gauge during vitreoretinal surgery under sub-Tenon's anesthesia.
In this prospective observational study, 63 patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia were enrolled between April and August 2023. The participants were asked to constantly compress a digital force gauge during the operation. The magnitude of the compressive force was directly proportional to the severity of pain they experienced. A Pain Index (PI) was derived from peak compressive force measurements to evaluate the intraoperative pain intensity. Immediately after the surgery, patients reported their intraoperative pain score and anxiety score using the Numerical Rating Scale (NRS). Concordance between PI and pain scores was analyzed using the intraclass correlation coefficient (ICC) and Kendall's tau-b analysis.
The PI was slightly higher than the patient-reported pain scores (1.37 ± 1.27 vs. 1.05 ± 1.28, P = 0.01). Complete consistency in values was observed in 33 cases (52.38%). Strong concordance emerged between PI and pain score (ICC = 0.75, 95% CI: 0.62-0.84; P < 0.01), along with a significant rank-order correlation (τ = 0.66, P < 0.01). Moreover, the PI showed a weaker correlation with anxiety score (τ = 0.32, P = 0.02) compared to pain score (τ = 0.51, P < 0.01).
The PI demonstrated favorable consistency and correlation with the conventional NRS for pain evaluation.
本研究旨在评估在球后麻醉下玻璃体视网膜手术中使用数字测力计进行实时术中疼痛评估的可行性。
在这项前瞻性观察研究中，纳入了2023年4月至8月期间63例接受球后麻醉下玻璃体视网膜手术的患者。要求参与者在手术过程中持续挤压数字测力计。挤压力的大小与他们所经历的疼痛严重程度成正比。通过峰值挤压力测量得出疼痛指数（PI），以评估术中疼痛强度。手术后，患者立即使用数字评分量表（NRS）报告他们的术中疼痛评分和焦虑评分。使用组内相关系数（ICC）和肯德尔tau-b分析来分析PI与疼痛评分之间的一致性。
PI略高于患者报告的疼痛评分（1.37±1.27对1.05±1.28，P = 0.01）。在33例（52.38%）中观察到数值完全一致。PI与疼痛评分之间出现了强一致性（ICC = 0.75，95%CI：0.62 - 0.84；P < 0.01），同时存在显著的等级相关性（τ = 0.66，P < 0.01）。此外，与疼痛评分（τ = 0.51，P < 0.01）相比，PI与焦虑评分的相关性较弱（τ = 0.32，P = 0.02）。
PI在疼痛评估方面与传统的NRS显示出良好的一致性和相关性。
