Pain induced by phacoemulsification without sedation using topical or peribulbar anesthesia.
OBJECTIVE
To evaluate patient-reported pain induced by phacoemulsification without sedation using topical or peribulbar anesthesia.


METHODS
Department of Ophthalmology, School of Medicine of Ribeirão Preto, São Paulo, Brazil.


METHODS
This study assessed patient-perceived pain during phacoemulsification cataract surgery with peribulbar anesthesia (lidocaine 2%-bupivacaine 0.5% mixture) or with topical anesthesia (tetracaine drops); no patient received sedation. The same surgeon performed all surgeries using a clear corneal approach and in-the-bag intraocular lens implantation. Approximately 15 minutes after surgery, patients in the topical anesthesia group (n = 20) were asked to rate their pain during the procedure and patients in the peribulbar anesthesia group (n = 21), during infiltration of the anesthetic solution. Patients graded their pain using a 0- to 10-point visual analog scale (0 = no pain; 10 = unbearable pain). The results in the 2 groups were compared using the nonparametric Mann-Whitney U test.


RESULTS
The median pain score in the topical anesthesia group was 2 (range 0 to 5) and in the peribulbar anesthesia group, 3 (range 0 to 7). The mean rank in the topical anesthesia group (15.78) was significantly lower than the mean rank in the peribulbar anesthesia group (25.98) (P = .0057, Mann-Whitney U test).


CONCLUSIONS
In patients having phacoemulsification without sedation, those receiving peribulbar anesthesia reported more pain than those receiving topical anesthesia during anesthetic solution infiltration and during the procedure, respectively.
Coelho
Roberto Pinto
RP
Department 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
Weissheimer
João
J
Romão
Erasmo
E
Velasco e Cruz
Antonio Augusto
AA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062365:Aminobenzoates / Q000008:administration & dosage; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D018918:Phacoemulsification / Q000009:adverse effects*
D062365:Aminobenzoates; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; C003636:tricaine; D008012:Lidocaine; D002045:Bupivacaine