Johannes Loeser1,2, Julian Schwemmer1,3, Antoniu-Oreste Gostian4,5, Magdalena Gostian1, Björn Bachmann3, Claus Cursiefen3, Ludwig M Heindl6. 1. Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany. 2. Department of Palliative Medicine, University of Cologne, Cologne, Germany. 3. Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany. 4. Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Erlangen, Germany. 5. Department of Otolaryngology, Head & Neck Surgery, University Hospital Cologne, Cologne, Germany. 6. Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany. ludwig.heindl@uk-koeln.de.
Abstract
PURPOSE: To evaluate postoperative pain following Descemet membrane endothelial keratoplasty (DMEK). METHODS: Seventy-one patients completed perioperatively (day before surgery, day of surgery, 1st, 2nd, and 3rd day after surgery) four different questionnaires (a hospital internal protocol, QUIPS, PainDETECT®, and SF36) regarding their pain and other clinical parameters such as constipation, tiredness, vertigo, sleep disorders, concentration disorders, nausea, and emesis. All standardised questionnaires were evaluated to quantify average pain intensity as well as maximum pain intensity (NRS, 0 [no pain] to 10 [maximal pain], respectively). Analgesic treatment and intraocular pressure (IOP) during the perioperative stay were documented. RESULTS: Mean average pain intensity was 0.70 ± 1.64 before surgery, 1.97 ± 2.05 on the day of surgery, 1.39 ± 1.68 on day 1, 0.87 ± 1.36 on day 2, and 0.81 ± 1.24 on day 3 after surgery. Maximum pain intensity was 0.65 ± 1.81 before surgery, 3.35 ± 2.98 on the day of surgery, 2.68 ± 2.99 on day 1, 1.49 ± 2.15 on day 2, and 1.26 ± 2.02 on day 3 after surgery. During the first three postoperative days, over 90% of the patients stated no or well tolerable pain. Eighty-three percent had postoperatively no need for analgesics at all. On the first two postoperative days, maximum IOP correlated significantly with reported increased maximum pain intensity (p = 0.043 and p = 0.029, respectively). All patients had very little problems with constipation, tiredness, vertigo, sleep disorder, concentration disorders, nausea, and emesis. CONCLUSIONS: DMEK is associated with low postoperative pain intensity. Strong pain increase may indicate IOP elevation and should be further investigated and treated. CLINICAL TRIAL REGISTRATION: German Clinical Trial Register (DRKS00013995).
PURPOSE: To evaluate postoperative pain following Descemet membrane endothelial keratoplasty (DMEK). METHODS: Seventy-one patients completed perioperatively (day before surgery, day of surgery, 1st, 2nd, and 3rd day after surgery) four different questionnaires (a hospital internal protocol, QUIPS, PainDETECT®, and SF36) regarding their pain and other clinical parameters such as constipation, tiredness, vertigo, sleep disorders, concentration disorders, nausea, and emesis. All standardised questionnaires were evaluated to quantify average pain intensity as well as maximum pain intensity (NRS, 0 [no pain] to 10 [maximal pain], respectively). Analgesic treatment and intraocular pressure (IOP) during the perioperative stay were documented. RESULTS: Mean average pain intensity was 0.70 ± 1.64 before surgery, 1.97 ± 2.05 on the day of surgery, 1.39 ± 1.68 on day 1, 0.87 ± 1.36 on day 2, and 0.81 ± 1.24 on day 3 after surgery. Maximum pain intensity was 0.65 ± 1.81 before surgery, 3.35 ± 2.98 on the day of surgery, 2.68 ± 2.99 on day 1, 1.49 ± 2.15 on day 2, and 1.26 ± 2.02 on day 3 after surgery. During the first three postoperative days, over 90% of the patients stated no or well tolerable pain. Eighty-three percent had postoperatively no need for analgesics at all. On the first two postoperative days, maximum IOP correlated significantly with reported increased maximum pain intensity (p = 0.043 and p = 0.029, respectively). All patients had very little problems with constipation, tiredness, vertigo, sleep disorder, concentration disorders, nausea, and emesis. CONCLUSIONS: DMEK is associated with low postoperative pain intensity. Strong pain increase may indicate IOP elevation and should be further investigated and treated. CLINICAL TRIAL REGISTRATION: German Clinical Trial Register (DRKS00013995).
Authors: Ludwig M Heindl; Stephan Riss; Bjoern O Bachmann; Kathrin Laaser; Friedrich E Kruse; Claus Cursiefen Journal: Ophthalmology Date: 2010-08-17 Impact factor: 12.079
Authors: M Matthaei; S Schrittenlocher; D Hos; S Siebelmann; F Bucher; F Schaub; R Hoerster; R Siggel; S Roters; L M Heindl; B Bachmann; C Cursiefen Journal: Ophthalmologe Date: 2019-03 Impact factor: 1.059
Authors: Franziska Bucher; Deniz Hos; Mario Matthaei; Philipp Steven; Claus Cursiefen; Ludwig M Heindl Journal: Cornea Date: 2014-11 Impact factor: 2.651
Authors: Ludwig M Heindl; Stephan Riss; Werner Adler; Franziska Bucher; Deniz Hos; Claus Cursiefen Journal: Ophthalmology Date: 2013-02-08 Impact factor: 12.079