European Journal of Anaesthesiology



Original Article

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


D. Henzler a1a2c1, R. Kramer a1, U. H. Steinhorst a1a3, S. Piepenbrock a1, R. Rossaint a2 and R. Kuhlen a2
a1 Medizinische Hochschule Hannover, Department of Anaesthesiology I, Hannover, Germany
a2 Universitätsklinikum, Department of Anaesthesiology, Aachen, Germany
a3 Dr.-Horst-Schmidt-Kliniken, Department of Ophthalmolgy, Wiesbaden, Germany

Article author query
henzler d   [PubMed][Google Scholar] 
kramer r   [PubMed][Google Scholar] 
steinhorst uh   [PubMed][Google Scholar] 
piepenbrock s   [PubMed][Google Scholar] 
rossaint r   [PubMed][Google Scholar] 
kuhlen r   [PubMed][Google Scholar] 

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.

(Accepted April 2003)


Key Words: ANAESTHESIA, GENERAL; ANAESTHESIA, REGIONAL, retrobulbar; POSTOPERATIVE COMPLICATIONS, PAIN, postoperative, measurement; SURGICAL PROCEDURES, ophthalmological.

Correspondence:
c1 Correspondence to: Dietrich Henzler, Department of Anaesthesiology, University Hospital Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany. E-mail: dhenzler@ukaachen.de; Tel: +49 0241 80 88179; Fax: +49 0241 80 82406


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