Pain induced by phacoemulsification without sedation using topical or peribulbar anesthesia.

摘要

Pinto Coelho et al. shared their study comparing pain induced by phacoemulsification using topical or peribulbar anesthesia. All 41 patients were interviewed retrospectively about their pain sensation. However, from the methodology, it appears the authors were actually comparing pain associated with phacoemulsification in the topical anesthesia group against pain induced by needling rather than the cataract extraction procedure itself in the peribulbar anesthesia group. This comparison suffers from the pitfalls of neither conforming to the original purpose of the study nor observing the fundamental physiological disparities between the pain sensations in these 2 groups.Pain induced by phacoemulsification may occur at any time during the surgery but has been observed to be related mostly to manipulation of uveal tissue or stretching of the capsule during hydrodissection. On the other hand, needling during the administration of peribulbar anesthetic triggers pain sensation from cutaneous receptors as well as those within periorbital tissues because of pressure effect and tissue edema. Comparison of these 2 study groups may appear dubious.