在局部镇静下发酵过程中疼痛的预测因素:一个多中心研究
E Debourdeau1, F Ortis2, C Chamard1
1Department of Ophthalmology, Gui-de-Chauliac Hospital, 80, avenue Augustin-Fliche, 34000 Montpellier, France; Institute for Neurosciences of Montpellier INM, University Montpellier, Inserm, 34091 Montpellier, France.
在白内障手术期间的疼痛与特定因素有关. 较低的眼内透镜功率 (<19 D),长期使用止痛药,棕色或白色白内障增加疼痛风险. 对这些患者来说,麻醉可能需要调整.
科学领域:
- 眼科医生 眼科 眼科
- 麻醉学 麻醉学
背景情况:
- 白内障手术通常在局部麻醉下进行.
- 在眼科手术过程中,患者的舒适性和疼痛管理至关重要.
研究的目的:
- 为了确定在局部麻醉下进行的白内障手术期间与疼痛相关的危险因素.
- 为了告知临床实践和改善患者的结果.
主要方法:
- 一项多中心观察性研究,涉及330名接受白内障手术的患者,接受局部麻醉和有意识镇静.
- 在去除窗后,使用数值评分尺度 (NRS) 评估疼痛.
- 多变量逻辑回归分析了临床和生物识别数据,以确定疼痛预测因子.
主要成果:
- 13.7%的患者报告疼痛 (NRS得分≥4).
- 疼痛的重要风险因素包括眼内透镜 (IOL) 功率<19 D (OR=2.78),慢性止痛药的使用 (OR=4.34),以及棕色或白色白内障类型 (OR=5.68).
结论:
- 麻醉方案应适用于具有特定危险因素的患者:近视眼 (IOL功率<19 D),使用慢性止痛药的人以及患有棕色或白色白内障的人.
- 进一步的研究可以开发一种可预测的疼痛评分,用于整合到生物识别设备中.
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