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Pain induced by phacoemulsification without sedation using topical or peribulbar anesthesia
Roberto Pinto Coelho1, João Weissheimer, Erasmo Romão
1Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. rpcoelho@keynet.com.br
Journal of Cataract and Refractive Surgery
|March 16, 2005
Summary
Phacoemulsification without sedation caused less pain with topical anesthesia compared to peribulbar anesthesia. Patients reported lower pain scores with topical anesthesia during cataract surgery.
Area of Science:
- Ophthalmology
- Anesthesiology
- Pain Management
Background:
- Cataract surgery, specifically phacoemulsification, is commonly performed with various anesthesia techniques.
- Sedation is often used in conjunction with anesthesia, but its necessity and impact on patient-reported pain are debated.
Purpose of the Study:
- To compare patient-reported pain during phacoemulsification cataract surgery performed without sedation.
- To evaluate pain experienced under topical anesthesia versus peribulbar anesthesia.
Main Methods:
- A comparative study involving two groups of patients undergoing phacoemulsification without sedation.
- One group received topical anesthesia (tetracaine drops), while the other received peribulbar anesthesia (lidocaine-bupivacaine mixture).
- Pain was assessed using a 0-10 visual analog scale, with statistical comparison via the Mann-Whitney U test.
Main Results:
- Patients receiving topical anesthesia reported a median pain score of 2 (range 0-5).
- Patients receiving peribulbar anesthesia reported a median pain score of 3 (range 0-7).
- The mean rank for pain was significantly lower in the topical anesthesia group (15.78) compared to the peribulbar anesthesia group (25.98) (P = .0057).
Conclusions:
- Peribulbar anesthesia was associated with greater patient-reported pain during phacoemulsification without sedation compared to topical anesthesia.
- Topical anesthesia may be a preferable option for managing pain in phacoemulsification when sedation is avoided.