Scientific correspondence
Vitreoretinal surgery: pre-emptive analgesia
Nadine Kristin, Carl L Schönfeld, Martin Bechmann, Mete Bengisu, Klaus Ludwig, Andreas Scheider, Anselm Kampik
Klinikum Innenstadt,
Munich, Germany
Correspondence to: Nadine Kristin, Klinikum Innenstadt, Mathildenstrasse 8, D-80336 Munich, Germany n.kristin{at}ak-i.med.uni-muenchen.de
Accepted for publication 19 April 2001
AIM
Vitrectomies are
performed either under general anesthesia (GA), local anesthesia (LA),
or a combination of both. Postoperative pain is expected to be less in
patients with LA because of prolonged action of the local anaesthetic.
Pre-emptive analgesia is based on the idea that analgesia initiated
before a nociceptive event will be more effective than analgesia
commenced afterwards. The authors compared postoperative analgesia in
patients with GA combined with preoperative or postoperative LA.
METHODS90 patients
scheduled for vitrectomy without buckling were enrolled in the study.
60 patients underwent GA, 30 without LA, 15 with preoperative LA, and
15 with postoperative LA. 30 patients received LA alone. Subjective
postoperative pain was determined using the visual analogue scale.
RESULTSPostoperative
pain was less under LA alone compared to GA alone (p < 0.0001).
Additional preoperative application of LA resulted in less pain than
additional postoperative application (p <0.05). Additional
postoperative peribulbar aneasthesia did not differ from GA alone.
CONCLUSIONThe authors
conclude that LA alone or preoperatively in addition to GA provides the
best comfort for the patient in vitreoretinal surgery.
© 2001 by British Journal of Ophthalmology
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This article has been cited by other articles:
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Ong, C. K.-S., Lirk, P., Seymour, R. A., Jenkins, B. J.
(2005). The Efficacy of Preemptive Analgesia for Acute Postoperative Pain Management: A Meta-Analysis. Anesth. Analg.
100: 757-773
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