Comparing the intraoperative pain severity in phacoemulsification cataract surgery under the topical anesthesia and systemic sedation in patients with hairy and normal eyebrow

Abstract

Background: We measured the sedation level, pain severity and patients’ and surgeon’s satisfaction in phacoemulsification cataract surgery with topical anesthesia and systemic sedation in patients with hairy normal eyebrow. Methods: In a randomized clinical trial study, 32 hairy-eyebrow and 32 normal-eyebrow patients with the age of over 60 years and The American Society of Anesthesiologists (ASA) grade of I or II undergoing phacoemulsification under topical anesthesia (tetracaine 0.5) and systemic sedation (1-1.5 μg/kg intravenous fentanyl) were studied. The intra and postoperative pain severity based on visual analog scale (VAS), sedation score based on Regional Assistance Mission to Solomon Islands (RAMSI) scale, mean arterial pressure and pulse rate, and patients’ and surgeon’s satisfaction were evaluated. Data was analyzed using chi-square and t tests. Findings: There was no significant difference between the two groups in age and weight. But, the mean height was significantly lower in hairy-eyebrow patients. The severity of intraoperative pain was significantly higher in hairy-eyebrow patients; the severity of postoperative pain was not significantly different. There was no statistically difference between the groups in sedation score (RAMSI) in different times, patients’ and surgeon’s satisfaction scores during operation, and the mean arterial pressure in 0, 5, 10 minutes. Conclusion: Our study shows that in cataract surgery under phacoemulsification, hairy-eyebrow patients need more sedative doses of drugs in comparison to normal-eyebrow patients, regarding their higher intraoperative pain severity. © 2015, Isfahan University of Medical Sciences(IUMS). All rights reserved.