Purpose

This study aimed to determine degree of postoperative pain and the incidence of serious postoperative pain after glaucoma surgery and further to identify the associated risk factors.

Methods

A total of 194 consecutive patients who were diagnosed with glaucoma and underwent glaucoma surgery were enrolled in this study. The intensity of postoperative pain was evaluated using numerical rating scale (NRS) within 24 h after surgery; NRS ≥ 5 was considered as clinically significant postoperative pain. Risk factors associated with the development of postoperative pain were analyzed by multivariate logistic regression analysis.

Results

Clinically significant postoperative pain was experienced at any time after glaucoma surgery in 41.75% of the patients, which peak at 2 h. 27.8% of the patients requested analgesic medication within 24 h after surgery. According to multivariate logistic regression analysis, preoperative anxiety (OR = 4.13 [1.29–13.2], p = 0.017), cyclophotocoagulation (OR = 30.9 [3.47–375.1], p = 0.002), and phacotrabeculectomy combined with or without intraocular lens implantation (OR = 30.0 [2.69–335.6], p = 0.006) were associated with increased clinically significant postoperative pain. Interestingly, patients with diabetes and/or hypertension were associated with less postoperative pain after glaucoma surgery (OR = 0.23 [0.08–0.64], p = 0.005).

Conclusion

Patients undergoing glaucoma surgery tend to experience postoperative pain in the early postoperative period. Anxiety level and surgery types of cyclophotocoagulation and phacotrabeculectomy are risk factors for postoperative pain. Patients with diabetes and/or hypertension are less likely to develop postoperative pain.

中文翻译：

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青光眼术后疼痛的相关危险因素：一项前瞻性研究

目的

本研究旨在确定青光眼手术后术后疼痛的程度和严重术后疼痛的发生率，并进一步确定相关的危险因素。

方法

共有 194 名被诊断患有青光眼并接受青光眼手术的连续患者参加了这项研究。术后 24 h 内采用数值评定量表（NRS）评估术后疼痛强度；NRS ≥ 5 被认为是有临床意义的术后疼痛。通过多因素逻辑回归分析分析与术后疼痛发展相关的危险因素。

结果

41.75% 的患者在青光眼手术后的任何时间都经历过临床上显着的术后疼痛，并在 2 小时达到峰值。27.8% 的患者在术后 24 小时内要求使用镇痛药物。根据多因素logistic回归分析，术前焦虑（OR = 4.13 [1.29-13.2]，p  = 0.017），睫状体光凝术（OR = 30.9 [3.47-375.1]，p  = 0.002）和超声小梁切除术联合或不联合人工晶状体植入术（ OR = 30.0 [2.69–335.6]，p  = 0.006）与临床上显着的术后疼痛增加相关。有趣的是，糖尿病和/或高血压患者在青光眼手术后术后疼痛较少（OR = 0.23 [0.08-0.64]，p  = 0.005）。

结论

接受青光眼手术的患者在术后早期往往会出现术后疼痛。焦虑水平和睫状体光凝术和超声小梁切除术的手术类型是术后疼痛的危险因素。糖尿病和/或高血压患者不太可能出现术后疼痛。