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Factors independently associated with increased risk of pain development after ophthalmic surgery

Published online by Cambridge University Press:  23 December 2004

D. Henzler ,
R. Kramer ,
U. H. Steinhorst ,
S. Piepenbrock ,
R. Rossaint  and
R. Kuhlen
D. Henzler
Affiliation:
Medizinische Hochschule Hannover, Department of Anaesthesiology I, Hannover, Germany Universitätsklinikum, Department of Anaesthesiology, Aachen, Germany
R. Kramer
Affiliation:
Medizinische Hochschule Hannover, Department of Anaesthesiology I, Hannover, Germany
U. H. Steinhorst
Affiliation:
Medizinische Hochschule Hannover, Department of Anaesthesiology I, Hannover, Germany Dr.-Horst-Schmidt-Kliniken, Department of Ophthalmolgy, Wiesbaden, Germany
S. Piepenbrock
Affiliation:
Medizinische Hochschule Hannover, Department of Anaesthesiology I, Hannover, Germany
R. Rossaint
Affiliation:
Universitätsklinikum, Department of Anaesthesiology, Aachen, Germany
R. Kuhlen
Affiliation:
Universitätsklinikum, Department of Anaesthesiology, Aachen, Germany
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Abstract

Summary

Background and objective: Little has been documented about the development of pain after ophthalmic surgery. This study was designed to assess the incidence and severity of postoperative pain following ophthalmic surgery, and to identify key factors independently associated with development of such pain.

Methods: In a prospective, observational cohort study, 500 patients undergoing elective ophthalmic surgery were examined by assessing numerical analogue scales and analgesic requirements.

Results: Depending on anatomical location of surgery, operations could be classified into creating ‘more severe’ or ‘less severe pain’. Patients undergoing posterior segment, corneal and muscle surgery exhibited the highest numerical analogue scale scores (risk ratio 4.5, 95% CI 3.01–6.79, P < 0.0001). Anterior segment surgery, which per se did not create much pain, resulted in significantly more pain when performed under general anaesthesia compared to regional anaesthesia (risk ratio 6.52, 95% CI 2.33–18.2, P < 0.0001). No other factors independently associated with an increased risk of developing serious postoperative pain could be identified.

Conclusions: Patients undergoing certain ophthalmic operations, especially if performed under general anaesthesia, are more likely to experience serious postoperative pain.

Keywords

ANAESTHESIA, GENERALANAESTHESIA, REGIONAL, retrobulbarPOSTOPERATIVE COMPLICATIONS, PAIN, postoperative, measurementSURGICAL PROCEDURES, ophthalmological
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 2 , February 2004 , pp. 101 - 106
Copyright
2004 European Society of Anaesthesiology

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References

Kristin N, Schonfeld CL, Bechmann M, et al. Vitreoretinal surgery: pre-emptive analgesia. Br J Ophthalmol 2001; 85: 1328–1331.Google Scholar
Henzler D, Müller-Kaulen B, Steinhorst UH, Broermann H, Piepenbrock S. The combination of retrobulbar block with general anaesthesia may lead to pre-emptive analgesia in patients undergoing pars plana vitrectomy. Anaesthesiol Intensivmed Notfallmed Schmerzther 2002; 37: 267–272.Google Scholar
Rawal N, Sjöstrand U, Christoffersson E, Dahlstrom B, Arvill A, Rydman H. Comparison of intramuscular and epidural morphine for postoperative analgesia in the grossly obese: influence on postoperative ambulation and pulmonary function. Anesth Analg 1984; 63: 583–592.Google Scholar
Scott NB, Kehlet H. Regional anaesthesia and surgical morbidity. Br J Surg 1988; 75: 299–304.Google Scholar
Tuman KJ, McCarthy RJ, March RJ, et al. Effects of epidural anesthesia and analgesia on coagulation and outcome after major vascular surgery. Anesth Analg 1991; 73: 696–794.Google Scholar
Duncan GH, Bushnell MC, Lavigne, GJ. Comparison of verbal and visual analogue scales for measuring the intensity and unpleasantness of experimental pain. Pain 1989; 37: 295–303.Google Scholar
Yarnitsky D, Sprecher E, Zaslansky R, Hemli JA. Multiple session experimental pain measurement. Pain 1996; 67: 327–333.Google Scholar
Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA. Studies with pain rating scales. Ann Rheum Dis 1978; 37: 378–381.Google Scholar
Ferraz MB, Quaresma MR, Aquino LRL, Atra E, Tugwell P, Goldsmith CH. Reliability of scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol 1990; 17: 1022–1024.Google Scholar
Jensen MP, McFarland CA. Increasing the reliability and validity of pain intensity measurement in chronic pain patients. Pain 1993; 55: 195–203.Google Scholar
Price DD, Bush FM, Long S, Harkins SW. A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain 1994; 56: 217–226.Google Scholar
Feitl ME. Anaesthesia. In: Krupin T, Kolker AE, eds. Complications of Ophthalmic Surgery.Baltimore, USA: Wolfe, 1993: 1–18.
Hamilton RC. Brain stem anesthesia following retrobulbar blockade. Anesthesiology 1985; 63: 688–690.Google Scholar
Rosenblatt RM, May DR, Barsonmian K. Cardiopulmonary arrest after retrobulbar block. Am J Ophthalmol 1980; 90: 425–427.Google Scholar
Wittpenn JR, Rapoza P, Sternberg P, Kuwashima L, Saklad J, Patz A. Respiratory arrest following retrobulbar anesthesia. Ophthalmology 1986; 93: 867–870.Google Scholar
Seitz W, Schäffer J. Perioperativer Stress bei Augenoperationen. In: Piepenbrock S, Schäffer J, eds. Anästhesie in der Augenheilkunde. Schriftenreihe Intensivmedizin, Notfallmedizin, Anästhesiologie. Stuttgart, Germany: Thieme, 1989: 45–54.
Woolf CJ, Chong MS. Preemptive analgesia – treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 1993; 77: 362–379.Google Scholar