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Pain perception in sequential cataract surgery: comparison of first and second procedures
Roxana Ursea1, Matthew T Feng, Michael Zhou
1Department of Ophthalmology and Vision Science, University of Arizona, Tucson, Arizona 85711-1824, USA.
Journal of Cataract and Refractive Surgery
|May 21, 2011
Summary
Second cataract extractions showed a slight increase in pain compared to the first, despite reduced anxiety. This subtle pain increase may be linked to sedation
Area of Science:
- Ophthalmology
- Anesthesiology
- Surgical Outcomes
Background:
- Cataract extraction is a common surgical procedure.
- Topical anesthesia with monitored anesthesia care is frequently used.
- Patient experience and pain perception are important outcomes.
Purpose of the Study:
- To compare pain and anxiety levels between the first and second cataract extractions.
- To investigate the relationship between anxiety and pain in sequential cataract surgery.
- To evaluate patient-reported outcomes under topical anesthesia with monitored anesthesia care.
Main Methods:
- A cohort study involving adult patients undergoing bilateral sequential cataract extraction.
- Patients received topical anesthesia with monitored anesthesia care.
- Pain was assessed using visual analog scales, and anxiety using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and State-Trait Anxiety Scale (STAI).
Main Results:
- A statistically significant increase in median pain scores was observed for the second cataract extraction (1 vs 0, P = .004).
- Forty percent of patients reported higher pain scores for the second surgery.
- Preoperative anxiety scores (APAIS and STAI) significantly decreased between the first and second surgeries (P = .003 and P < .001, respectively).
Conclusions:
- While cataract extraction remains largely painless, a subtle increase in pain occurs during the second procedure.
- Decreased preoperative anxiety and potential amnestic effects of sedation may influence pain perception.
- These findings offer insight into patient experiences with sequential cataract surgery.
