title: Pain induced by phacoemulsification without sedation using topical or peribulbar anesthesia.
abstract: 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.
authors.affiliation: 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
authors.forename: Roberto Pinto
authors.initials: RP
authors.lastname: Coelho
authors.forename: João
authors.initials: J
authors.lastname: Weissheimer
authors.forename: Erasmo
authors.initials: E
authors.lastname: Romão
authors.forename: Antonio Augusto
authors.initials: AA
authors.lastname: Velasco e Cruz
mesh_terms: 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*
chemical_list: D062365:Aminobenzoates; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; C003636:tricaine; D008012:Lidocaine; D002045:Bupivacaine