Preoperative Anxiety Levels and Pain during Cataract Surgery

Socea, Sergiu; Abualhasan, Hamza; Magen, Or; Zayit‐Soudry, Shiri; Blumenthal, Eytan Z.; Duvdevan, Nitsan

doi:10.1080/02713683.2019.1666996

Cited by 26 publications

(24 citation statements)

References 26 publications

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“…Moreover, preoperative anxiety level was found to be the only significant predictor of pain during cataract surgery. 5 …”

Section: Resultsmentioning

confidence: 99%

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Fear and Anxiety Associated with Cataract Surgery Under Local Anesthesia in Adults: A Systematic Review

Obuchowska¹,

Konopińska²

2021

PRBM

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Cataract surgery is one of the most frequently performed surgical procedures worldwide. Patients usually experience strong negative emotions, such as fear and anxiety. A systematic review of the recent literature regarding the emotional states experienced during cataract surgery under local anaesthesia was performed based on the PubMed and Scopus databases. The objective of this review was to determine the causes and frequency of fear and anxiety, as well as methods for improving intraoperative experience and supporting the patient prior to surgery. Anxiety is mainly caused by fear of the surgery itself, fright of pain, and loss of vision. Abstaining and visual sensations experienced during cataract surgery also increased the preoperative anxiety. Women and hypochondriacs showed higher levels of anxiety. The greatest intensity of negative emotions occurred on the day of the cataract surgery. Patients operated on both eyes experienced greater fear and anxiety before the operation of the first eye surgery. In order to reduce patients’ negative experiences, pharmacological sedation, preoperative education and counselling, manual massage immediately before surgery, and listening to music during surgery are used. Taking this information into consideration allows the introduction of effective methods of eliminating the patient’s negative feelings in connection with cataract surgery, which leads to an improvement in the results of the operation and an increase in the patients’ sense of satisfaction and quality of life.

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“…Moreover, preoperative anxiety level was found to be the only significant predictor of pain during cataract surgery. 5 …”

Section: Resultsmentioning

confidence: 99%

“…Fear and anxiety are the dominant and most frequently reported negative feelings related to cataract surgery. 5–13 However, it is difficult to estimate the number of patients who experience them. Data vary depending on the study group, ophthalmic center, and phase of the entire procedure analyses were carried out.…”

Section: Resultsmentioning

confidence: 99%

Fear and Anxiety Associated with Cataract Surgery Under Local Anesthesia in Adults: A Systematic Review

Obuchowska¹,

Konopińska²

2021

PRBM

View full text Add to dashboard Cite

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“…One potential limitation of our study was the administration of intravenous midazolam prior to sub-Tenon or peribulbar injection; however, this single dose of midazolam was provided to patients in both study groups and, therefore, cannot explain the difference in pain level ratings between the groups. Another point to consider is that preoperative anxiety has been reported to be associated with intraoperative pain perception [ 47 , 48 ], and the sub-Tenon approach may be associated with less anxiety than the retrobulbar approach since patients receiving sub-Tenon anesthesia do not see a needle moving toward them as is the case with peribulbar injections [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Pain during pars plana vitrectomy following sub-Tenon versus peribulbar anesthesia: A randomized trial

Ribeiro

Abrão

et al. 2020

PLoS ONE

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Purpose To compare pain during pars plana vitrectomy (PPV) following topical lidocaine jelly and sub-Tenon anesthesia versus peribulbar anesthesia. Methods Prospective, single-center, randomized study. Patients scheduled for PPV for macular hole (MH) or epiretinal membrane (ERM) at the Retina and Vitreous Section of the Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo were randomly assigned to one of two groups in a 1:1 allocation ratio. Patients assigned to Group ST received topical anesthesia with 2% lidocaine jelly followed by sub-Tenon anesthesia with 2–4 ml of 1% ropivacaine. Patients assigned to PB received peribulbar anesthesia with 4–6 ml of 1% ropivacaine. After PPV, patients in both groups were asked to rate the level of pain they felt during the entire procedure (including anesthesia administration and PPV) by pointing at a 0–100 Visual Analogue Pain Scale (VAS). Data regarding demographics, patient characteristics and surgical features were also collected. Results Fifty-four patients were enrolled in the study (26 in Group ST and 28 in Group PB). Baseline characteristics, including age, gender, and presence of comorbidities, were similar in both groups. The surgery performed was PPV alone in 10 and 14 patients in the ST and PB groups, respectively, and combined phacoemulsification and PPV in 16 and 14 patients in the ST and PB groups, respectively (p = 0.39, Pearson). Surgery duration (mean ± SD minutes) was similar in the two groups (62 ± 12 for ST and 70 ± 20 for PB, p = 0.09, t-Test). No patients needed supplemental topical or intravenous anesthesia during surgery. No sight- or life-threatening complication was observed in either group. VAS score was significantly lower in the ST compared to the PB group (median (interquartile range) was 1 (2.25–0) in the ST group compared to 11.5 (29.75–5) in the PB group, p< 0.0001, Wilcoxon). Conclusion In this study of patients who underwent PPV for MH or ERM, topical followed by sub-Tenon anesthesia was more effective in controlling pain during the whole vitrectomy procedure than peribulbar anesthesia. Compared to peribulbar anesthesia which is administered with a sharp needle, sub-Tenon anesthesia administered with a blunt cannula may be associated with a reduced risk of such adverse events as globe perforation, retrobulbar hemorrhage, and inadvertent injection of anesthesia into the optic nerve sheath.

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“…However, in recent years, more and more observations indicated that there was more pain in the second eye compared with the first eye after the cataract surgery (Tan et al, 2011;Ursea et al, 2011;Adatia et al, 2015;Jiang et al, 2015;Yu et al, 2016;Liu et al, 2020). While in most of the previous studies the pain was measured by the VAS (Sharma et al, 2008;Gayadine-Harricham and Amzallag, 2017;Socea et al, 2020), individual differences in pain sensitivity and perception may lead to biases in the results of the study. Thus, in this study, we applied rabbit and rat lens surgery models and recapitulated CSF3 expression changes observed in patients.…”

Section: Discussionmentioning

confidence: 99%

Sympathetic Nerve-Mediated Fellow Eye Pain During Sequential Cataract Surgery by Regulating Granulocyte Colony Stimulating Factor CSF3

Fan

et al. 2022

Front. Cell. Neurosci.

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Patients were found to experience more pain during their second eye cataract surgery compared with their first eye surgery. This study aimed to explore the inflammatory alterations along time in the fellow eye after the first eye surgery and to reveal the underlying mechanism. Eighty patients with bilateral cataracts were recruited and were divided into four groups based on the time of having the second eye surgery. The second eye aqueous humor samples were collected just before surgery and analyzed by mass spectrometry and PCR array. Cytokine activity was enriched in the aqueous humor of the contralateral eye with granulocyte colony-stimulating factor CSF3 significantly upregulated at both gene and protein levels. Rabbits with or without superior cervical ganglionectomy (SCGx) were subjected to lensectomy to mimic human situations. In both human and rabbit models, the fellow eye CSF3 peaked at 1 week post the first eye surgery. Consistently, more neutrophils were recruited to the contralateral eye aqueous humor. Corneal sensitivity and trigeminal electrophysiology were recorded to imply the pain severity in rats receiving capsulorrhexis with or without SCGx. A more intense pulse was detected in the contralateral trigeminal ganglion after the rat received one eye surgery. SCGx could effectively reduce the fellow corneal sensitivity and trigeminal nerve pain. These alterations were under direct regulation of the sympathetic nerves on the surgical eye side. Our results suggest that CSF3 and sympathetic activity could serve as potential analgesic targets during ocular surgeries.

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Preoperative Anxiety Levels and Pain during Cataract Surgery

Cited by 26 publications

References 26 publications

Fear and Anxiety Associated with Cataract Surgery Under Local Anesthesia in Adults: A Systematic Review

Fear and Anxiety Associated with Cataract Surgery Under Local Anesthesia in Adults: A Systematic Review

Pain during pars plana vitrectomy following sub-Tenon versus peribulbar anesthesia: A randomized trial

Sympathetic Nerve-Mediated Fellow Eye Pain During Sequential Cataract Surgery by Regulating Granulocyte Colony Stimulating Factor CSF3

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