Anaesthesia for phacosemulsification surgery: is it as comfortable as we think?
We report an observational prospective study to determine which local anaesthetic technique gave the most comfort during phacoemulsification (cataract) surgery. 1835 patients were recruited. 61.8% were female. Peribulbar (18.2%), subtenons (28.6%), and topical (53.2%) anaesthesia was used. The pain score was assessed by the visual analogue pain scale (VAPS) which ranged from 0 (no pain) to 10 (worse possible pain). The lowest mean pain score occurred in the subtenons group, mean VAPS 0.2 (95% CI 0.1-0.3). The mean pain scores for topical and peribulbar anaesthesia were 0.6 (95% CI 0.5-0.7) and 0.59 (95% CI 0.41-0.76) respectively. Subtenons anaesthesia gave the most comfort during phacoemulsification. Patients experienced more discomfort with 2nd eye surgery. Older patients and males had a higher pain threshold in all three anaesthetic groups.
Department of Surgery, Anaesthesia, Radiology and Intensive Care, University Hospital of the West Indies, Mona, Jamaica. lizettemowatt@yahoo.com
Lizette
L
Mowatt
Evelyn
E
Youseff
Maria
M
Langford
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods* / Q000523:psychology; D001294:Attitude to Health; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D015404:Nursing Methodology Research; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D010147:Pain Measurement; D018918:Phacoemulsification / Q000009:adverse effects* / Q000523:psychology; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome