Comparison of analgesic effect of preoperative topical diclofenac and ketorolac on postoperative pain after photorefractive keratectomy

Hong, Jin Pyo; Nam, Sang Min; Im, Chan Young; Yoon, Sangchul; Kim, Tae Im; Kim, Eung Kweon; Seo, Kyoung Yul

doi:10.1016/j.jcrs.2014.05.029

Cited by 19 publications

(18 citation statements)

References 31 publications

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“…It peaked at 24 h in the moderate to severe range, with a VAS value of 6 mm. It was then stable until 36 h, before it began to decrease until 72 h. This finding is in agreement with other studies 16–18. To avoid delayed epithelialization, our postoperative analgesic protocol did not utilize either topical nonsteroidal anti-inflammatory or other drugs.…”

Section: Discussionsupporting

confidence: 90%

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Pain perception description after advanced surface ablation

Sobas

Videla

Vázquez

et al. 2017

OPTH

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PurposeThe objective of this study was to characterize the evolution of ocular pain after advanced surface ablation (ASA) to improve strategies in postoperative pain management.MethodsThis was a multicenter, prospective, descriptive, cohort study. The inclusion criteria were healthy individuals ≥18 years old receiving bilateral alcohol-assisted surface ablation with epithelial removal. Pain intensity was evaluated with the visual analog scale (VAS) and the numeric pain rating scale before and after surgery. Comorbidities (photophobia, burning, tearing, and foreign body sensation) and Hospital Anxiety and Depression (HAD) questionnaire were evaluated before and at 6 hours after surgery. Postoperative treatments included cold patch, topical cold antibiotics, topical steroids, and benzodiazepines.ResultsThirty-two consecutive patients having similar profiles of postoperative pain evolution were included. At 0.5 hour after ASA, the pain score by VAS was 37±20 mm, and the maximum pain, 61±31 mm, occurred at 24 hours. Afterward, it decreased progressively until 72 hours after surgery (19±20 mm). Most patients (81%) scored >60 mm, and 44% required rescue medication. Among the comorbidities, all patients had photophobia and 84% had burning sensation. At 6 hours, the HAD score was 5.4±3.9, within the range of values considered as normal.ConclusionPostoperative acute ocular pain after ASA showed a characteristic evolution over time. Recognition of the pattern could be important for improving the acceptance of ASA and for improving strategies in pain management in the postoperative period.

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Section: Discussionsupporting

confidence: 90%

“…Some other studies determined if several drugs could decrease the rate of corneal re-epithelialization, but assessment of pain was not the main outcome 2,16…”

Section: Discussionmentioning

confidence: 99%

Pain perception description after advanced surface ablation

Sobas

Videla

Vázquez

et al. 2017

OPTH

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“…Our results confirm previous studies showing that ASA produces severe pain in postoperative period, reaching a moderate-high intensity (VAS value of 6) with a peak of pain located between 24 and 36 hrs. 18,29,30 Although the VAS has been universally validated for the measurement of pain, it has obvious limitations. 31 Thus, there is a general consensus that new objective measures of pain are required, including salivary biomarkers.…”

Section: Discussionmentioning

confidence: 99%

<p>Evaluation of Potential Pain Biomarkers in Saliva and Pain Perception After Corneal Advanced Surface Ablation Surgery</p>

Sobas¹,

Vázquez²,

Videla³

et al. 2020

OPTH

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Purpose: To evaluate the evolution of a set of proposed pain biomarkers in the saliva of subjects following Advanced Surface Ablation (ASA), in order to determine their validity as objective pain measures. Methods: A multicenter, prospective, and descriptive study was carried out to assess the variations between biomarkers and perceived pain. The Inclusion criteria were healthy subjects who underwent a bilateral, alcohol-assisted surface ablation with epithelial removal (ASA). Pain intensity before and after surgery was assessed by Visual Analog Scale (VAS) and the Numeric Pain Rating Scale (NPRS). Cortisol, sAA, sIgA, testosterone, and sTNFαRII were assayed at four-time points (V0, baseline; V1, pre-surgery; V2, 1 hr postsurgery, and V3, 72 hrs post-surgery). Comorbidities and Hospital Anxiety and Depression (HADS) questionnaires were administrated before and at 6 hrs after the surgery. All patients were treated with cold patches, topical steroids, topical cold antibiotics, and benzodiazepines after ASA surgery. A descriptive analysis of biomarkers and pain intensity evolution and the agreement between biomarkers and pain was performed. Results: Concentration of sIgA and sTNFαRII post-surgery was significantly higher at each visit compared to baseline (p-value: 0.053, p-value: <0.001, respectively). Relations between VAS scale score and putative biomarker variations were not statistically significant except for the sIgA but only at visit 0 (p-value: 0.024). The HADS questionnaire showed anxiety scores between 0 and 7 in all patients before and at 6 hrs after surgery. Conclusion: In this study, sIgA and sTNFαRII are the two potential biomarkers that present correlation with the VAS and these salivary substances showed acceptable levels of reproducibility in healthy subjects.

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“…Generalmente, los estudios están diseñados para analizar si los tratamientos que se aplican en el postoperatorio retrasan la epitelización corneal y la valoración del dolor no es el propósito principal. 3,133 Los resultados que se obtuvieron estuvieron de acuerdo con otros estudios. La curva de dolor experimentó un rápido crecimiento hasta las 9h después de la cirugía, el pico máximo de dolor fue a las 24 horas, con un valor de 6, se estabilizó hasta 48h y empezó a disminuir hasta 72 horas.…”

Section: Características De Los Pacientesunclassified

“…La curva de dolor experimentó un rápido crecimiento hasta las 9h después de la cirugía, el pico máximo de dolor fue a las 24 horas, con un valor de 6, se estabilizó hasta 48h y empezó a disminuir hasta 72 horas. 36,133,134 Como se ha mencionado, una limitación importante de la cirugía de ASA es la existencia de molestias en el postoperatorio. 4,5 Después de dolor postoperatorio, en este estudio, la fotofobia fue el síntoma más frecuente presente en el 100% de los sujetos y con las puntuaciones más altas.…”

Section: Características De Los Pacientesunclassified

Validación de un modelo clínico en humanos para la evaluación del dolor agudo postoperatorio

Abad¹,

María²

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Comparison of analgesic effect of preoperative topical diclofenac and ketorolac on postoperative pain after photorefractive keratectomy

Abstract: No author has a financial or proprietary interest in any material or method mentioned.

Cited by 19 publications

References 31 publications

Pain perception description after advanced surface ablation

Pain perception description after advanced surface ablation

<p>Evaluation of Potential Pain Biomarkers in Saliva and Pain Perception After Corneal Advanced Surface Ablation Surgery</p>

Validación de un modelo clínico en humanos para la evaluación del dolor agudo postoperatorio

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