Incidence and Risk Factors of Moderate to Severe Postoperative Pain Following the Placement of Primary and Secondary Orbital Implants: A Prospective Observational Study
- PMID: 32282646
- DOI: 10.1097/IOP.0000000000001664
Incidence and Risk Factors of Moderate to Severe Postoperative Pain Following the Placement of Primary and Secondary Orbital Implants: A Prospective Observational Study
Abstract
Purpose: To prospectively explore the incidence and risk factors of moderate to severe pain after primary and secondary orbital implantation following evisceration or enucleation surgery.
Methods: One hundred eighteen patients under general anesthesia for orbital implantation were enrolled in this study. In 91 patients, primary orbital implantation followed evisceration, and in 27 patients, the implantation was secondary after previous evisceration or enucleation surgery. Medical interventions for all participants were followed by standardized surgical, anesthetic, and analgesic protocols. Postoperative pain (POP) intensity was quantified by an 11-point numerical rating scale within 72 hours after the surgery, numerical rating scale ≥4 was considered moderate to severe POP. Multivariate logistic regression was utilized to identify the risk factors related to the development of POP.
Results: Thirty-five patients (29.7%) displayed moderate to severe POP, particularly within 6 to 24 hours after surgery, which peaked at 24 hours. Of these patients, 26 patients who were unable to tolerate the pain received additional doses of analgesics during in-hospital stay. Logistic regression model revealed that preoperative anxiety (odds ratios = 4.890; p = 0.002), congenital microphthalmia (odds ratios = 14.602; p = 0.038), and surgical time longer than 60 minutes (odds ratios = 5.586; p = 0.001) were significantly associated with moderate to severe POP after orbital implantation.
Conclusions: Orbital implantation after evisceration or enucleation surgery is likely to cause moderate to severe pain intensity in the early postoperative period. Preoperative anxiety, prolonged surgical time, and congenital microphthalmia were the risk factors.
Copyright © 2020 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
Conflict of interest statement
The authors have no conflicts of interest to disclose.
References
-
- Keilani C, Baus A, Tick S, et al. Effectiveness and safety comparison of three eye and orbital reconstruction techniques in facial plastic surgery. Ann Chir Plast Esthet 2019;64:351–361.
-
- Hui JI. Outcomes of orbital implants after evisceration and enucleation in patients with endophthalmitis. Curr Opin Ophthalmol 2010;21:375–379.
-
- Ye H, Chen R, Lian X, et al. Risk factors associated with postoperative pain and discomfort in oculoplastic surgery with general anesthesia: a prospective study. J Pain Res 2018;11:407–415.
-
- Waterman H, Leatherbarrow B, Slater R, et al. The hydroxyapatite orbital implant: post-operative pain. Eye (Lond) 1998;12pt 6996–1000.
-
- Lesin M, Sundov ZD, Jukic M, et al. Postoperative pain in complex ophthalmic surgical procedures: comparing practice with guidelines. Pain Med 2014;15:1036–1042.
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