Postoperative Pain Control Following Vitreoretinal Surgery
| Status: | Completed |
|---|---|
| Conditions: | Post-Surgical Pain, Ocular, Ocular |
| Therapuetic Areas: | Musculoskeletal, Ophthalmology |
| Healthy: | No |
| Age Range: | 18 - 89 |
| Updated: | 4/21/2016 |
| Start Date: | July 2012 |
| End Date: | December 2015 |
The Effects of Triamcinolone Acetonide With Retrobulbar Anesthesia on Postoperative Pain Control Following Vitreoretinal Surgery
The aim of this study is to evaluate if patients receiving a steroid (triamcinolone
acetonide) combined with local anesthesia and antibiotic following retina surgery have
better postoperative pain control those receiving local anesthesia and antibiotic alone.
acetonide) combined with local anesthesia and antibiotic following retina surgery have
better postoperative pain control those receiving local anesthesia and antibiotic alone.
Currently, patients undergoing vitreoretinal surgery at the Emory Eye Center and Emory
University Hospital receive a injection of local anesthesia behind the eye (retrobulbar) at
the start of surgery to minimize discomfort felt during the surgery. At the end of surgery
all patients receive a periocular antibiotic and steroid injection. Some patients also
receive a retrobulbar injection of local anesthesia (bupivicaine) at the conclusion of
surgery in order to decrease postoperative pain and discomfort.
It has been our observation that when the local anesthesia is combined with a steroid
(triamcinolone acetonide) in a retrobulbar injection at the conclusion of surgery, patients
tend to be pain free for longer intervals then when local anesthesia is used alone. The
objective of this study is to evaluate if patients receiving triamcinolone acetonide
combined with local anesthesia and antibiotic compared to those receiving local anesthesia
and antibiotic alone do better with postoperative pain control.
All eligible patients undergoing vitreoretinal surgery at the Emory Eye Center and Emory
University Hospital will be offered enrollment. About 60 patients will be invited to
participate in this study. Patients will undergo standard of care surgery. At the conclusion
of surgery, patients will receive a retrobulbar antibiotic and anesthetic as standard of
care. Half of the patients will receive this mixture plus steroid and the other half will
receive this mixture plus saline. On postoperative day 1, patients will be given a
questionnaire to assess pain. Pain levels in the two groups will be compared.
University Hospital receive a injection of local anesthesia behind the eye (retrobulbar) at
the start of surgery to minimize discomfort felt during the surgery. At the end of surgery
all patients receive a periocular antibiotic and steroid injection. Some patients also
receive a retrobulbar injection of local anesthesia (bupivicaine) at the conclusion of
surgery in order to decrease postoperative pain and discomfort.
It has been our observation that when the local anesthesia is combined with a steroid
(triamcinolone acetonide) in a retrobulbar injection at the conclusion of surgery, patients
tend to be pain free for longer intervals then when local anesthesia is used alone. The
objective of this study is to evaluate if patients receiving triamcinolone acetonide
combined with local anesthesia and antibiotic compared to those receiving local anesthesia
and antibiotic alone do better with postoperative pain control.
All eligible patients undergoing vitreoretinal surgery at the Emory Eye Center and Emory
University Hospital will be offered enrollment. About 60 patients will be invited to
participate in this study. Patients will undergo standard of care surgery. At the conclusion
of surgery, patients will receive a retrobulbar antibiotic and anesthetic as standard of
care. Half of the patients will receive this mixture plus steroid and the other half will
receive this mixture plus saline. On postoperative day 1, patients will be given a
questionnaire to assess pain. Pain levels in the two groups will be compared.
Inclusion Criteria:
- Patients undergoing vitreoretinal surgery at the Emory Eye Center Ambulatory Surgery
Center and Emory University Hospital by retina attending faculty surgeons
Exclusion Criteria:
- Unable to verbalize level of pain control
- Pediatric patients (<18 years old)
- Glaucoma, ocular hypertension, or glaucoma suspects
- Allergy to local anesthetic
- Pre-existing chronic pain requiring narcotic pain medication
- Drug addiction
- Impaired periorbital sensation (history of herpes simplex, zoster, corneal graft)
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