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• W2065760783 abstract "Current local practice for patients undergoing vitrectomy involves general anaesthesia with or without topical analgesics, with regular simple analgesics and opioid-based analgesics as required postoperatively. No local anaesthetic eye blocks are currently inserted. A literature search on Medline revealed no trials comparing local anaesthetic eye blocks with oral and topical analgesia. We reviewed local practice to assess whether it might be beneficial to use local anaesthetic blocks to improve analgesia after vitrectomy. Patients undergoing vitrectomy were seen pre-operatively and given a questionnaire enquiring about anxiety levels and expectations of pain. The patients were followed up postoperatively and further questionnaires enquired about analgesia given intraoperatively; postoperative nausea and vomiting; time to eating and drinking; and pain scores. The patients were asked to take further questionnaires home to assess pain relief on the second and third postoperative days. Pain was assessed using verbal scoring. Over the one-month period a total of 15 patients were recruited. Response rate was 80% (12/15). Pain was found to be worst on day 1 and minimal by day 3. Five out of 12 patients reported moderate to severe pain on day 1. This was associated with nausea and vomiting in four cases. Of these, three patients received opioid-based analgesics such as codeine and tramadol. In the group reporting no pain or mild discomfort (seven cases), no patient received opioid analgesics. Patients who complained of nausea and vomiting (four cases) had an average time to eating and drinking of 3.56 h compared to 2.21 h in the group without nausea and vomiting (eight cases). There was a positive relationship between anxiety levels pre-operatively and pain scores postoperatively (Pearson correlation coefficient 0.86). Present standards of analgesia appear unsatisfactory. The simple analgesics used are inadequate in a large proportion of cases. Patients with higher pain scores are those who are more anxious pre-operatively, for whom opioid analgesics are prescribed and who complain of nausea and vomiting with a longer period before normal oral intake is resumed. This may have implications for certain patient groups (e.g. diabetics). Introduction of local anaesthetic eye blocks in addition to regular simple analgesics such as paracetamol and NSAIDs might reduce pain scores over the initial difficult 24 h. Use of opioid-based analgesics should be avoided if possible, as these seem to increase the incidence of postoperative nausea and vomiting." @default.
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• W2065760783 date "2003-04-15" @default.
• W2065760783 modified "2023-10-18" @default.
• W2065760783 title "Ophthalmic pain following vitrectomy: an audit of current practice" @default.
• W2065760783 doi "https://doi.org/10.1046/j.1365-2044.2003.03094_1.x" @default.
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