A comparison of patient pain and visual outcome using topical anesthesia versus regional anesthesia during cataract surgery

Hosoda, Yasuhiro; Kuriyama, Sei; Jingami, Yoko; Hattori, Hidetsugu; Hayashi, Hisako; Matsumoto, Miho

doi:10.2147/opth.s109360

Cited by 10 publications

(5 citation statements)

References 20 publications

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“…Given the advancements in equipment and the proficiency of surgical skills, topical anesthesia is the preferred method in phacoemulsification surgery to avoid the risks associated with local (retrobulbar or peribulbar) anesthesia, such as chemosis, ecchymosis, retrobulbar hemorrhage, globe penetration, or perforation; 1 , 2 however, phacoemulsification with topical anesthesia is not a completely painless procedure, with patients frequently experiencing pain during the surgery. 1 , 3 – 6 In a study comparing topical anesthesia and local anesthesia for phacoemulsification surgery, about 30.1% of patients with topical anesthesia complained of intraoperative pain, while only 6.7% of patients with local anesthesia reported intraoperative pain. 7 In another study, 78.3% of patients reported experiencing pain during phacoemulsification surgery with topical anesthesia; when the intensity of pain was evaluated, the percentage of patients reporting mild, moderate, and intense pain was 35.9%, 25.0%, and 17.4%, respectively.…”

Section: Introductionmentioning

confidence: 99%

Hypnosis intervention for the management of pain perception during cataract surgery

Chen¹,

Yuan²,

Chen³

et al. 2018

JPR

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ObjectiveTo investigate the effectiveness of hypnosis in pain management during cataract surgery.MethodsMale or female patients with bilateral age-related cataract who wished to have both eyes subjected to phacoemulsification surgery were preliminarily admitted. Immediately after the first-eye surgery, each patient was evaluated for pain using the visual analog scale (VAS), and patients with a VAS score >1 were enrolled. By using block randomization, the enrolled patients were allocated to either the treatment group, which received a hypnosis intervention before the scheduled second-eye surgery, or the control group, which did not undergo hypnosis. The levels of anxiety, pain, and cooperation were evaluated independently by the patients and the surgeon.ResultsDuring the intraoperative pain assessment, 5%, 34%, 38%, and 23% of patients in the control group reported experiencing no pain, mild pain, moderate pain, and severe pain, respectively. In contrast, in the hypnosis group, 18%, 56%, 15%, and 11% of patients reported experiencing no pain, mild pain, moderate pain, and severe pain, respectively, which showed significant differences between the groups (P<0.005). The evaluation of anxiety level showed that the mean score in the control group and hypnosis group was 11.77±0.32 and 6.64±0.21, respectively, revealing a highly significant difference between the two groups (P<0.005). The assessment of patient cooperation showed that only 5% and 18% of patients in the control group and 18% and 36% of patients in the hypnosis group showed excellent and good cooperation, respectively, while 47% of patients in the control group and only 24% of patients in the hypnosis group exhibited poor cooperation, revealing significant differences between the groups (P<0.005).ConclusionHypnosis may be considered as an auxiliary measure in cataract surgery, especially for patients who experienced obvious pain during the first-eye surgery.

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Section: Introductionmentioning

confidence: 99%

Hypnosis intervention for the management of pain perception during cataract surgery

Chen¹,

Yuan²,

Chen³

et al. 2018

JPR

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“…In addition, a particular attention should be paid to the patient's ability to communicate, to lie flat and keep still, and to follow instructions. A history of congestive heart failure, chronic obstructive pulmonary disease, chronic bronchitis, claustrophobia, anticoagulation status, and use of alpha-blockers (tamsulosin) should be addressed in each patient [35]. One should kept in mind that each technique has its own advantages and disadvantages, and the anesthesia provider should select the anesthesia technique Anesthetic agent is injected into the orbit, inside of the muscle cone.…”

Section: Conflict Of Interestmentioning

confidence: 99%

Local Anesthesia Techniques for Ocular Surgery

Akkaya¹,

Wang²

2018

Transl Perioper & Pain Med

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Several anesthesia techniques are available for modern intraocular surgery. When choosing the technique, the anesthetic targets and individual characteristics for each patient should be considered. Cataract is one of the common surgeries in the elderly with chronic coronary diseases, resulting in ischemic events during general anesthesia. Thus, regional aesthesia is generally preferable due to its advantages and lower complication rates. Various local anesthesia techniques are available for ocular surgery including retrobulbar (intraconal), peribulbar (extraconal), sub-Tenon's, limbal, intracameral, and topical anesthesia. In this review, we discuss the advantages and disadvantages of such techniques.

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“…In a comparative study of topical, intracameral and sub-Tenon anesthesia, Hosada et al [27] 2016 reported that intracameral (0.1-0.2 cc) infusion of 1% preservative-free lidocaine into the anterior chamber through the side port combined with topical drops of lidocaine provides sufficient pain suppressive effects in eyes without high myopia, while sub-Tenon anesthesia is better for cataract surgery in eyes with high myopia. Pandey et al [28] reported no difference in pain score between with topical anaesthesia and no aneathesia during cataract surgery (p = 0.610) though patient discomfort and surgeon stress were greater in the no anesthesia group.…”

Section: Comparison Of Pain Scorementioning

confidence: 99%

Local Anaesthesia in Cataract Surgery

Reddy

Thevi

2017

International Journal of Ophthalmic Research

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nerves of the cornea and the conjunctiva (long and short ciliary nerves, nasociliary nerves). This technique eliminates the possible complications of injectable anesthesia. However, it does not eliminate pain sensitivity of the iris, the zonule, and the ciliary body which is achieved by intracameral technique of anesthesia with preservative free 1% lidocaine. In a constantly evolving arena, the sub-Tenon's block has gained popularity while the deep angulated intraconal (retrobulbar) block has been largely superseded by the shallower extraconal (peribulbar) approach. Hyaluronidase is a useful adjuvant because it promotes local anesthetic diffusion and hastens block onset time but there is a possibility of getting an allergic reaction. Ultrasound-guided eye blocks afford real-time visualization of needle position and local anesthetic spread. An advantage of sonic guidance is that it may eliminate the hazard of globe perforation by identifying abnormal anatomy, such as staphyloma. INTRODUCTIONThe ideal anaesthesia would be one that provides adequate pain relief during surgery and postoepratively, be easy to administer and have minimal complications. For doing cataract surgery, the anaesthesia could be local or general. Majority of cataract patients are operated under local anaesthesia (infiltration, topical, intracameral). The infiltration anaesthesia is given as retrobulbar or peribulbar or subTenon's block. Carl Koller first used cocaine as a topical anaesthetic for eye surgery in 1884 [1] . The general anaesthesia has its own complications in elderly cataract patients and most of them may have diabetes or hypertension or heart diseases or combination of them. No need of fasting before or after surgery, no need of intubation, no need of using any systemic medications are the advantages of local anaesthesia. However, cataract in children, patients with parkinsonism, deaf mute patients, mental retardation patients, patients ABSTRACTThere has been a significant evolution in surgical technique of cataract extraction. The technical advances in phaco machines, phacotips, and availability of ophthalmic viscoelastic devices have played a great role in cataract surgery to be faster and more controlled now than before. Similarly, local anesthesia techniques in cataract surgery have also advanced significantly from retrobulbar, peribulbar, sub-Tenon's, to topical anaesthesia. Even though, the sub-Tenon's anesthesia technique reduced the risk of complications of peribulbar/ retrobulbar anesthesia but the technique is still associated with a possibility of damage to optic nerve, retrobulbar hemorrhage, and ocular muscle injury. Topical anesthesia is used to block the afferent EDITORIAL

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A comparison of patient pain and visual outcome using topical anesthesia versus regional anesthesia during cataract surgery

Cited by 10 publications

References 20 publications

Hypnosis intervention for the management of pain perception during cataract surgery

Hypnosis intervention for the management of pain perception during cataract surgery

Local Anesthesia Techniques for Ocular Surgery

Local Anaesthesia in Cataract Surgery

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