Preemptive analgesia of nepafenac 0.1% in retinal photocoagulation

Abstract

Recebido para publicação em 13/06/2014 -Aceito para publicação em 11/07/2014 Os autores declaram não haver conflitos de interesseObjetivo: Avaliar o efeito preemptivo com nepafenaco 0,1% em pacientes submetidos à fotocoagulação da retina para tratamento da retinopatia diabética proliferativa. Métodos: Trinta pacientes foram submetidos à fotocoagulação com laser de argônio em ambos os olhos. O olho contralateral de cada paciente foi o controle. O nepafenaco e o placebo foram utilizados 30 minutos antes da aplicação do laser. Ambos os olhos foram fotocoagulados no mesmo dia. A intensidade da dor foi avaliada por meio da escala analógica visual e da escala descritiva de dor. Resultados: A análise da interação instilação versus nepafenaco mostrou que os pacientes do grupo placebo apresentaram níveis de dor semelhantes em ambos os olhos, e os do grupo nepafenaco apresentaram redução importante do nível de dor no olho em que foi instilado a suspensão de 0,1% quando comparado ao olho contralateral que recebeu placebo (p=0,023). Conclusão: Este estudo sugere que a suspensão de 0,1% de nepafenaco foi útil na analgesia preemptiva de pacientes submetidos à fotocoagulação de retina quando comparada ao placebo.Descritores: Dor/prevenção & controle; Analgesia; Anti-inflamatórios não esteroides/administração & dosagem; Anti-inflamatórios não esteroides/uso terapêutico; Fotocoagulação; Retinopatia diabética/quimioterapia ABSTRACT RESUMOObjective: To evaluate the preemptive effect of nepafenac 0,1% in patients undergoing retinal photocoagulation for the treatment of proliferative diabetic retinopathy. Methods: Thirty patients underwent argon laser photocoagulation in both eyes. The contralateral eye of each patient was the control. The nepafenac and placebo were used 30 minutes before the application of the laser. Both eyes were photocoagulated in the same day. Pain intensity was assessed by visual analog scale and descriptive pain scale. Results: The analysis of the interaction instillation versus nepafenac showed that patients in the placebo group had similar levels of pain in both eyes, and the nepafenac group had significant reduction in pain in the eye that was instilled suspension of 0,1% when compared to the contralateral eye which received placebo (p = 0.023). Conclusion: This study suggests that a suspension of 0,1% nepafenac helpful for preemptive analgesia in patients undergoing retinal photocoagulation compared to placebo.

Efeito analgésico da música durante a fotocoagulação retinal a laser em diabéticos: Um estudo cruzado, randomizado e controlado por placebo

“…Acute procedural pain is still a neglected phenomenon in health care (Cakmak et al, 2017;Lee, 2016;Song et al, 2018), particularly in ophthalmic procedures (Araújo et al, 2015;Castro et al, 2014;Chen et al, 2012;Chiu & Wu, 2011;Quigley et al, 2019;Ramezani et al, 2017;Santo et al, 2016). These findings corroborate our results, since most of the patients who underwent argon LRP reported pain, despite the anesthetic used, which demonstrates the nociceptive nature of the procedure.…”

“…The ophthalmologists performed standardization by providing as much power and quantity of laser as possible, between 400 and 600 shots per session, which assumes that the final laser energy received was as corresponding as possible, in order for the analyses to be comparable, while the area treated in the first session, in the right eye, was the same as on the second day of treatment, in the left eye (Araújo et al, 2015;Castro et al, 2014;Chiu & Wu, 2011;Ko et al, 2009;Ramezani et al, 2017;Richardson, Waterman, 2009). Procedural pain from LRP can cause deleterious effects and ineffectiveness of therapy.…”

“…In order for the analyses to be comparable, the technique to encircle the posterior pole of the retina (around the vascular arches) was standardized. The LRP technique in our test was standardized for bias reduction and was based on previous studies that showed no significant difference in the presence of pain in relation to the power of the laser shots provided (Araújo et al, 2015;Castro et al, 2014;Chiu & Wu, 2011;Ko, Shim, Lee, & Cho, 2009;Ramezani et al, 2017;Richardson & Waterman, 2009).…”