Pain experience in patients undergoing topical anesthesia alone versus topical plus intracameral anesthesia during cataract surgery.

PURPOSE: To evaluate and compare the pain experience and discomfort during cataract surgery and over the 24 hours after surgery in patients undergoing either topical anesthesia alone or topical anesthesia plus intracameral anesthesia, provided by using a standard topical anesthesia regimen and a 0.2-mL dose of Mydrane®. METHODS: Prospective study involving 100 patients who underwent cataract surgery receiving either topical anesthesia alone (group 1, n = 50) or topical anesthesia plus intracameral anesthesia (group 2, n = 50) between January 2021 and March 2022. The pain experienced by patients during and after surgery was assessed using a pain scale and a questionnaire. One hour after surgery, patients were asked to rate the intensity of discomfort they experienced throughout the procedure by pointing to a 0-100 Visual Analogue Scale (VAS). RESULTS: According to VAS measurements, patients who underwent surgery under topical anesthesia reported more significant pain than those who underwent surgery under topical anesthesia plus intracameral anesthesia during and over the 24 hours after surgery. (p = 0.02 and p = 0.01, respectively). Patients undergoing topical anesthesia had 2.34-fold greater odds of having pain during surgery [95% Confidence Interval (CI): 1.58-5.25, p = 0.03]. CONCLUSIONS: Topical anesthesia plus intracameral anesthesia lower intraoperative and postoperative pain levels, improving patient cooperation and representing a useful analgesic delivery method in cataract surgery.

COMPARISON OF PAIN EXPERIENCE IN PATIENTS UNDERGOING SUB-TENON'S ANESTHESIA VERSUS PERIBULBAR ANESTHESIA DURING ELECTIVE VITREORETINAL SURGERY.

PURPOSE: To assess and compare the patients' discomfort and pain experienced during anesthesia, pars plana vitrectomy, and 24 hours postoperatively after sub-Tenon's injection (STI) versus peribulbar block (PB) in elective vitreoretinal surgery. METHODS: Retrospective study involving 80 patients who underwent elective vitreoretinal surgery receiving either PB (Group 1, n = 40) or STI (Group 2, n= 40) between January 2021 and March 2022. Patients' pain experienced during the procedure and 24 hours postoperatively were assessed using a pain scale and a two-section questionnaire. One hour postoperatively, patients were asked to rate the level of pain they felt during the entire procedure by pointing at a 0 to 100 Visual Analog Scale. Subsequently, patients answered a two-section questionnaire regarding pain and discomfort felt 24 hours postoperatively. RESULTS: According to Visual Analog Scale measurements, patients experienced significantly more pain during PB than during STI 1 hour after surgery. Patients undergoing PB experienced more pain than those who underwent STI, experiencing burning and discharge feeling. Patients undergoing STI had a lower pain level score 24 hours postoperatively despite similar discomfort. CONCLUSION: Sub-Tenon's injection has a lower pain score than PB during the procedure and 24 hours postoperatively, representing a valuable procedure to deliver analgesia in vitreoretinal surgery.