Interventions for relieving pain associated with panretinal photocoagulation: a prospective randomized trial

Wc, Wu; Hsu, Kuang‐Hung; Tl, Chen; Ys, Hwang; Lin, Ken‐Kuo; Lm, Li; Cp, Shih; Lai, C-C

doi:10.1038/sj.eye.6701989

Cited by 38 publications

(35 citation statements)

References 50 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…PRP can be a painful procedure for many patients, and when performed under peribulbar block, it is significantly less painful than topical anaesthesia, even when augmented with intramuscular or oral analgesics. 3 Better tolerance of the procedure also allows for quicker and more complete treatment. The perceived disadvantage of performing complete PRP in one session is the possible increase in complications, such as macular oedema and choroidal effusions.…”

Section: Introductionmentioning

confidence: 99%

Routine, single session, indirect laser for proliferative diabetic retinopathy

Tinley

Gray

2009

Eye

View full text Add to dashboard Cite

Aims To evaluate the visual and morphological outcomes of routine, single session, indirect panretinal photocoagulation (PRP) for proliferative diabetic retinopathy, and to examine adverse events related to indirect laser within the first 8 weeks of treatment. Methods The case notes of 107 diabetics with proliferative retinopathy undergoing indirect PRP were reviewed retrospectively, and compared with the UK National Diabetic Retinopathy Laser Treatment Audit. Patients who had received PRP previously were excluded. Follow-up data were collected as close as possible to 9 months following the initial laser treatment. Results Fifteen patients (14.0%) returned with adverse events within the first 8 weeks of indirect PRP. There were two tractional retinal detachments and two new vitreous haemorrhages. One patient with underlying neurotrophic keratopathy developed a persistent epithelial defect. One developed non-progressive macular drag with a one-line drop in Snellen acuity. Three experienced new or exacerbations of preexisting clinically significant macular oedema, which resolved spontaneously. There were two transient choroidal effusions, two transient anterior uveitis, and two transient visual deteriorations without macular oedema clinically. There were no significant differences in the rates of new tractional retinal detachment, vitreous haemorrhage or rubeosis, but our vitrectomy rate was higher (7.5 vs 1.5%, P ¼ 0.02, v 2 ), largely due to our policy of performing vitrectomy early. Conclusions Visual and morphological outcomes of routine, single session, indirect PRP for proliferative diabetic retinopathy were not inferior to the outpatient-based national audit, and the incidence of significant PRP-induced adverse events was low.

show abstract

Section: Introductionmentioning

confidence: 99%

Routine, single session, indirect laser for proliferative diabetic retinopathy

Tinley

Gray

2009

Eye

View full text Add to dashboard Cite

show abstract

“…The pain ranges from mild to severe, and may in some cases be intolerable, becoming necessary to use general anesthesia or anesthetic block. Both procedures increase the risk of future morbidity and even mortality (4) . Some works tried to demonstrate the significant reduction of pain with the use of various methods, since paracetamol, acupuncture to general anesthesia (1,3,4) , and the use of analgesics in a preemptive way for said procedure is not established.…”

mentioning

confidence: 99%

“…Both procedures increase the risk of future morbidity and even mortality (4) . Some works tried to demonstrate the significant reduction of pain with the use of various methods, since paracetamol, acupuncture to general anesthesia (1,3,4) , and the use of analgesics in a preemptive way for said procedure is not established. It has not been found in the literature studies using metamizole, despite being widely used in our environment for reducing pain in general (5,6) .…”

mentioning

confidence: 99%

Preemptive analgesia of metamizole versus ibuprofen in retinal laser photocoagulation

Santo¹,

Auge²,

Ferraz³

2016

Revista Brasileira De Oftalmologia

View full text Add to dashboard Cite

Objective: To compare the effectiveness of metamizole versus ibuprofen for the reduction of pain in retinal photocoagulation (RP). RESUMOObjetivo: Comparar a efetividade da dipirona versus o ibuprofeno para a redução da dor na fotocoagulação da retina (FR). Método: Foi realizado um estudo controlado, duplo cego e randomizado englobando trinta e quatro pacientes com retinopatia diabética separados em dois grupos. Grupo A recebeu 1000mg de dipirona e o grupo B recebeu 600mg de ibuprofeno. A dor foi avaliada pela escala visual analógica. Resultado: A média do escore da dor nos grupos A e B foi de 5,2 ± 2.6 e 4,5 ± 1,4, respectivamente. Não houve diferença estatística entre os grupos (p=0,34). O mesmo foi observado quanto à analise entre dor leve, moderada e grave (p=0,09). Os grupos foram semelhantes quanto à idade e sexo. Conclusão: Os medicamentos foram equivalentes ou equipotentes em reduzir a dor ocular durante a fotocoagulação a laser da retina.

show abstract

“…4,5 Undertreatment could lead to accelerated loss of sight, hence good pain management during the therapy might significantly affect the rate of blindness within people with proliferative diabetic retinopathy. 6,7 There are several published papers exploring the efficacy of analgesics for PRP despite the fact that it has not been established within the literature that PRP using argon laser is actually painful. 4,[6][7][8] Common analgesics used in PRP are Entonox, paracetamol, various nonsteroidal anti-inflammatory drugs (NSAIDs), diazepam, and peribulbar anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 There are several published papers exploring the efficacy of analgesics for PRP despite the fact that it has not been established within the literature that PRP using argon laser is actually painful. 4,[6][7][8] Common analgesics used in PRP are Entonox, paracetamol, various nonsteroidal anti-inflammatory drugs (NSAIDs), diazepam, and peribulbar anaesthesia. Despite this the most clinically effective analgesic is unknown.…”

Section: Introductionmentioning

confidence: 99%

Pain relief during panretinal photocoagulation for diabetic retinopathy: a national survey

Richardson

Waterman

2009

Eye

View full text Add to dashboard Cite

Aims Panretinal photocoagulation (PRP) for proliferative retinopathy is known to be painful for some people; however, few studies have explored the effects of pain on the procedure within clinical practice. Methods This was a national survey of all Ophthalmic Units within the UK undertaken in late 2006. A questionnaire with 14 questions was developed, piloted, and sent to all NHS units in the UK. Results A 77% response rate was achieved. The vast majority of responses (96%) were from doctors. A large proportion (79%) of units see up to 20 cases a week and most patients require up to 5 sessions of PRP. Eighty-eight percent said that the procedure is painful. Once present, pain can affect the number and strength of burns delivered and indirectly increases the number of sessions required to complete the therapy. Sub-tenons anaesthesia was the most commonly used analgesic and there is some tentative evidence to support its effect. Few units have a pre-emptive analgesic protocol. Some respondents were using laser with lower exposure and reported reduced pain. Conclusions PRP is painful; however, most units do not deliver pain relief pre-emptively. There may be a case to support the routine use of sub-tenons anaesthesia until the full effects of new laser techniques become known.

show abstract

Interventions for relieving pain associated with panretinal photocoagulation: a prospective randomized trial

Cited by 38 publications

References 50 publications

Routine, single session, indirect laser for proliferative diabetic retinopathy

Routine, single session, indirect laser for proliferative diabetic retinopathy

Preemptive analgesia of metamizole versus ibuprofen in retinal laser photocoagulation

Pain relief during panretinal photocoagulation for diabetic retinopathy: a national survey

Contact Info

Product

Resources

About