Sadiq S A, Stevenson L, Gorman C, Orr G M
Department of Ophthalmology, Queen's Medical Centre, Nottingham.
Br J Ophthalmol. 1998 Apr;82(4):429-31. doi: 10.1136/bjo.82.4.429.
BACKGROUND/AIMS: Patients undergoing scleral buckling and cryotherapy suffer from mild to moderate postoperative pain. As good pain relief facilitates post-operative ocular examination, as well as patient comfort and recovery, the authors designed a prospective randomised double masked trial to evaluate the efficacy of indomethacin as a satisfactory analgesic for such patients.
Patients with a primary uncomplicated rhegmatogenous retinal detachment requiring scleral buckling and cryotherapy were randomly allocated to receive either indomethacin or placebo. A rectal suppository was administered 2 hours before surgery, followed by two capsules twice daily for 10 days. Pain relief was assessed with a linear graphic rating scale at the end of each day. Supplementary analgesia was allowed and recorded.
12 patients received indomethacin (group A) and 16 received placebo (group B). The extent of surgery was similar in both groups. One patient in group A, and two in group B withdrew after 3 days. The pain scores were converted to changes from the baseline (score on day 1), and the area under the curve calculated for each patient. The means of the areas were analysed with the Mann-Whitney test and showed that indomethacin caused a statistically significant reduction in pain score, both at 3 days (p = 0.04) and at 10 days (p = 0.014). There was no statistically significant difference in extra analgesic requirements between the two groups (p = 0.2).
Indomethacin is recommended for short to medium term pain relief following scleral buckling and cryotherapy.
背景/目的：接受巩膜扣带术和冷冻疗法的患者术后会遭受轻至中度疼痛。由于良好的疼痛缓解有助于术后眼部检查以及患者的舒适度和恢复，作者设计了一项前瞻性随机双盲试验，以评估吲哚美辛作为此类患者满意镇痛药的疗效。
患有原发性单纯性孔源性视网膜脱离且需要巩膜扣带术和冷冻疗法的患者被随机分配接受吲哚美辛或安慰剂。术前2小时给予直肠栓剂，随后每天两次服用两粒胶囊，持续10天。每天结束时用线性图形评分量表评估疼痛缓解情况。允许并记录补充镇痛情况。
12例患者接受吲哚美辛治疗（A组），16例接受安慰剂治疗（B组）。两组手术范围相似。A组1例患者和B组2例患者在3天后退出。将疼痛评分转换为相对于基线（第1天的评分）的变化，并计算每位患者的曲线下面积。用Mann-Whitney检验分析面积均值，结果显示吲哚美辛在3天时（p = 0.04）和10天时（p = 0.014）均使疼痛评分有统计学意义的降低。两组之间额外镇痛需求无统计学显著差异（p = 0.2）。
推荐吲哚美辛用于巩膜扣带术和冷冻疗法后的短期至中期疼痛缓解。
