J Korean Ophthalmol Soc.  2015 May;56(5):715-720. 10.3341/jkos.2015.56.5.715.

The Comparison of Post-Operative Pain between Topical Anesthesia and Monitored Anesthesia Care in Cataract Surgery

• Kim SD
• Jeong JH

• KMID: 2121169
• DOI: http://doi.org/10.3341/jkos.2015.56.5.715

Abstract

PURPOSE
To compare pain levels in cataract surgery under topical anesthesia only and topical anesthesia under monitored anesthesia care.
METHODS
We recruited 243 patients who were scheduled to undergo cataract surgery under topical anesthesia only or topical anesthesia with monitored anesthesia care (MAC) using fentanyl and midazolam. Anesthesia methods were selected based on the patient's preference. All patients completed an anxiety and information scale survey preoperatively. Vital signs during the operations were recorded. A 0-to-10 visual analog scale pain score survey was conducted immediately and at 2 hours, 6 hours, and 1 day after surgery.
RESULTS
Of the 237 patients who completed the study, 183 patients selected topical anesthesia, and 54 patients selected MAC. Mean pain scores according to the aforementioned time points after surgery were 0.50, 0.58, 0.29, and 0.12 in the topical anesthesia group, and 0.22, 0.16, 0.06, and 0.09 in the MAC group, respectively. The differences in pain score between the two groups was statistically significant at 2 hours (p = 0.019) and 6 hours (p = 0.040) after surgery. The mean patient anxiety score for anesthesia was 10.50 in the topical anesthesia group and 11.41 in the MAC group (p = 0.280). Mean systolic blood pressure at the start of surgery was 140.6 mm Hg in the topical anesthesia group, and 158.2 mmHg in the MAC group.
CONCLUSIONS
Monitored anesthesia care consistently resulted in less pain throughout the post-operative period. However, transient systolic blood pressure should be carefully monitored for a rise related to intravenous anesthetics.

Keyword

Cataract surgery; Monitored anesthesia care; Pain

MeSH Terms

Anesthesia*
Anesthetics, Intravenous
Anxiety
Blood Pressure
Cataract*
Fentanyl
Humans
Midazolam
Visual Analog Scale
Vital Signs
Anesthetics, Intravenous
Fentanyl
Midazolam

Figure

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  Figure 1. Subjective postOperative pain score using 0-to-10 Visual Analogue Scale (VAS) Cataract surgery using MAC consistently offered less pain throughout the postOperative period and the difference was statistically significant at postop 2 hour and 6 hour. MAC = monitored anesthesia care; op = operation. * Statistically significant ( p < 0.05).

Reference

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