Risk factors associated with postoperative pain and discomfort in oculoplastic surgery with general anesthesia: a prospective study

Abstract

Purpose: To evaluate patient pain and discomfort following oculoplastic surgery performed under general anesthesia and to assess key factors associated with postoperative pain and discomfort.

Methods: A prospective observational cohort study was conducted among 212 consecutive patients who underwent oculoplastic surgery performed under general anesthesia. The patients were assessed according to quantified levels of pain and discomfort postoperatively. Analgesic requests were recorded, and responses were statistically analyzed.

Results: Pain and discomfort after oculoplastic surgery under general anesthesia were reported by 32.1% and 28.3% of the patients, respectively; 2.8% of the patients requested analgesic medication within 18 hours after surgery. The patients who underwent orbital decompression, secondary orbital implantation, and orbital fracture repair were more likely to develop significant postoperative pain and discomfort (P<0.001), and the patients who underwent enucleation/evisceration during orbital implantation were more likely to develop postoperative discomfort (P<0.001). The predictors of pain were smoking history, prior surgery on the operative eye, and anxiety (P<0.05), and the predictor of discomfort was anxiety (P<0.05).

Conclusion: Patients undergoing oculoplastic surgery tend to experience postoperative pain and discomfort. Anxiety is a risk factor for both postoperative pain and discomfort, while smoking history and prior surgery on the operative eye may be associated with postoperative pain.

Keywords: Chinese; discomfort level; ophthalmic surgery; pain level; prevalence; related factors.

Figure 1

The mean numerical rating scale (NRS) scores for pain 0 to 24 hours after recovery from general anesthesia. Note: Groups 1, 5, and 6 had significantly higher postoperative pain scores than Groups 2, 3, 4, and 7. Group 1, orbital decompression; Group 2, orbital tumour extirpation; Group 3, enucleation or evisceration with orbital implantation; Group 4, extensive excision of eyelid/conjunctiva/sclera/choroid tumour; Group 5, secondary orbital implantation; Group 6, orbital fracture repair; Group 7, strabismus surgery.

Figure 2

The mean numerical rating scale (NRS) scores for discomfort 0 to 24 hours after recovery from general anesthesia. Note: Groups 1, 3, 5, and 6 had significantly higher postoperative discomfort scores than Groups 2, 4, and 7. Group 1, orbital decompression; Group 2, orbital tumour extirpation; Group 3, enucleation or evisceration with orbital implantation; Group 4, extensive excision of eyelid/conjunctiva/sclera/choroid tumour; Group 5, secondary orbital implantation; Group 6, orbital fracture repair; Group 7, strabismus surgery.