Abstract
Purpose :
Retinal specialists continue to debate the best method for achieving adequate analgesia prior to intravitreal injections. This was an observational study at a large academic center to assess whether differences in analgesic procedure resulted in differences in pain levels.
Methods :
Observational study of patients receiving intravitreal anti-VEGF injections at a university medical center. Inclusion criteria included any patient receiving anti-VEGF injections. Data including age, race, gender, diagnosis, number of injections at given visit, speculum use, and anti-VEGF medication administered were collected. Data regarding the numbing procedure were recorded including all times relative to injection and number of separate administrations of proparacaine, betadine, and akten gel. Patients were asked to rate their pain at the time of injection on a scale of 1-10 using a visual analog pain scale.
Results :
85 patients and 103 total eyes were injected. Those who received more than one drop of proparacaine perceived less pain than those receiving one or zero drops (2.13 vs. 3.27, p=0.019). Pain scores decreased with longer intervals from last akten gel administration to time of injection (3.33 for under 5 minutes vs. 2.86 for 6-10 minutes vs. 2.08 for over 11 minutes, p=0.08). While not statistically significant, patients who received injections from residents or fellows perceived higher pain scores than those from attending physicians (3.47 vs. 2.64, p=0.10). No statistically significant difference in pain perception was found based on demographic differences, medication injected, or speculum use. No difference was found regarding number of administrations or timing of proparacaine or betadine. Additionally, there was no statistically significant difference in pain scores regarding number of administrations of akten gel.
Conclusions :
Only those who received more than one proparacaine drop were found to have statistically significant lower scores than those who received one or zero drops. Most variables measured in this study led to no difference in pain score. The data from this study can be used to improve the analgesia and overall patient experience prior to receiving intravitreal injections.
This is a 2021 ARVO Annual Meeting abstract.