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Observational Study
. 2025 Aug 28;45(1):359.
doi: 10.1007/s10792-025-03734-9.

Intraoperative pain assessment using a digital force gauge during vitreoretinal surgery: a prospective feasibility study

De-Zhi Zheng  1 , Wei-Qi Chen  2 , Zi-Jing Huang  2 , Ding-Guo Huang  2 , Pei-Min Lin  2
Affiliations
Observational Study

Intraoperative pain assessment using a digital force gauge during vitreoretinal surgery: a prospective feasibility study

De-Zhi Zheng et al. Int Ophthalmol. .

Abstract

Purpose: This study aimed to evaluate the feasibility of real-time intraoperative pain assessment using a digital force gauge during vitreoretinal surgery under sub-Tenon's anesthesia.

Methods: In this prospective observational study, 63 patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia were enrolled between April and August 2023. The participants were asked to constantly compress a digital force gauge during the operation. The magnitude of the compressive force was directly proportional to the severity of pain they experienced. A Pain Index (PI) was derived from peak compressive force measurements to evaluate the intraoperative pain intensity. Immediately after the surgery, patients reported their intraoperative pain score and anxiety score using the Numerical Rating Scale (NRS). Concordance between PI and pain scores was analyzed using the intraclass correlation coefficient (ICC) and Kendall's tau-b analysis.

Results: The PI was slightly higher than the patient-reported pain scores (1.37 ± 1.27 vs. 1.05 ± 1.28, P = 0.01). Complete consistency in values was observed in 33 cases (52.38%). Strong concordance emerged between PI and pain score (ICC = 0.75, 95% CI: 0.62-0.84; P < 0.01), along with a significant rank-order correlation (τ = 0.66, P < 0.01). Moreover, the PI showed a weaker correlation with anxiety score (τ = 0.32, P = 0.02) compared to pain score (τ = 0.51, P < 0.01).

Conclusion: The PI demonstrated favorable consistency and correlation with the conventional NRS for pain evaluation.

Keywords: Analog pain scale; Local anesthesia; Ophthalmic surgery; Pain evaluation.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflict of interest. Ethics approval and consent to participate: This study protocol was approved by the Ethics Committee of the Joint Shantou International Eye Center, with the designated approval number EC 20191108(5)-P07. It was conducted by the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all subjects before the study. Consent for publication: Not Applicable. (No information or images could lead to the identification of a study participant in this manuscript.)

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