Immediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty (DMEK) under general anaesthesia: a pilot retrospective analysis
Abstract Background Patients undergoing corneal abrasion as part of Descemet membrane endothelial keratoplasty (DMEK) under general anesthesia suffer from early burning pain postoperatively. This pain appears to be poorly treatable with systemic analgesics. This study aims to evaluate postoperative...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-023-02258-y |
| _version_ | 1797451735033184256 |
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| author | Nicolas Leister Björn Bachmann Mario Matthaei Uwe Trieschmann Christine Schumacher Vanessa Löw Bernd W. Böttiger Silvia Schrittenlocher Ludwig M. Heindl Claus Cursiefen |
| author_facet | Nicolas Leister Björn Bachmann Mario Matthaei Uwe Trieschmann Christine Schumacher Vanessa Löw Bernd W. Böttiger Silvia Schrittenlocher Ludwig M. Heindl Claus Cursiefen |
| author_sort | Nicolas Leister |
| collection | DOAJ |
| description | Abstract Background Patients undergoing corneal abrasion as part of Descemet membrane endothelial keratoplasty (DMEK) under general anesthesia suffer from early burning pain postoperatively. This pain appears to be poorly treatable with systemic analgesics. This study aims to evaluate postoperative pain management using topical lidocaine gel after DMEK with iatrogenic corneal abrasion. Methods Retrospective analysis of 28 consecutive patients undergoing DMEK with corneal abrasion from October 19, 2021, to November 12, 2021, at a German university hospital. Patients during week 1 and 2 received peri-operative standard pain treatment (cohort S) and additional local lidocaine gel during week 3 and 4 immediately postoperatively (cohort L). Results 13 patients were included in cohort S and 15 patients in cohort L. At awakening all patients (100%) in cohort S reported burning pain, and six of 15 patients (40%) in cohort L reported burning pain. Burning pain scores were significantly lower in cohort L (p < 0.001 at awakening, p < 0.001 at 10 min, p < 0.001 at 20 min, p < 0.001 at 30 min, p = 0.007 at 40 min after awakening, and p < 0.001 at leaving recovery room). No significant differences between cohort S and cohort L were detected concerning surgical outcome during 1-month-follow-up (p = 0.901 for best corrected visual acuity). Conclusion Patients undergoing DMEK with corneal abrasion suffer significant pain in the recovery room. A single dose of topic lidocaine gel reduces the early postoperative burning pain sufficiently and does not affect the surgical outcome. |
| first_indexed | 2024-03-09T14:57:47Z |
| format | Article |
| id | doaj.art-15c9420109804937b8fe08134bb77431 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-09T14:57:47Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-15c9420109804937b8fe08134bb774312023-11-26T14:02:56ZengBMCBMC Anesthesiology1471-22532023-09-012311610.1186/s12871-023-02258-yImmediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty (DMEK) under general anaesthesia: a pilot retrospective analysisNicolas Leister0Björn Bachmann1Mario Matthaei2Uwe Trieschmann3Christine Schumacher4Vanessa Löw5Bernd W. Böttiger6Silvia Schrittenlocher7Ludwig M. Heindl8Claus Cursiefen9Department of Anesthesiology and Intensive Care Medicine, University Hospital CologneDepartment of Ophthalmology, Faculty of Medicine, University of Cologne, University Hospital CologneDepartment of Ophthalmology, Faculty of Medicine, University of Cologne, University Hospital CologneDepartment of Anesthesiology and Intensive Care Medicine, University Hospital CologneDepartment of Anesthesiology and Intensive Care Medicine, University Hospital CologneDepartment of Anesthesiology and Intensive Care Medicine, University Hospital CologneDepartment of Anesthesiology and Intensive Care Medicine, University Hospital CologneDepartment of Ophthalmology, Faculty of Medicine, University of Cologne, University Hospital CologneDepartment of Ophthalmology, Faculty of Medicine, University of Cologne, University Hospital CologneDepartment of Ophthalmology, Faculty of Medicine, University of Cologne, University Hospital CologneAbstract Background Patients undergoing corneal abrasion as part of Descemet membrane endothelial keratoplasty (DMEK) under general anesthesia suffer from early burning pain postoperatively. This pain appears to be poorly treatable with systemic analgesics. This study aims to evaluate postoperative pain management using topical lidocaine gel after DMEK with iatrogenic corneal abrasion. Methods Retrospective analysis of 28 consecutive patients undergoing DMEK with corneal abrasion from October 19, 2021, to November 12, 2021, at a German university hospital. Patients during week 1 and 2 received peri-operative standard pain treatment (cohort S) and additional local lidocaine gel during week 3 and 4 immediately postoperatively (cohort L). Results 13 patients were included in cohort S and 15 patients in cohort L. At awakening all patients (100%) in cohort S reported burning pain, and six of 15 patients (40%) in cohort L reported burning pain. Burning pain scores were significantly lower in cohort L (p < 0.001 at awakening, p < 0.001 at 10 min, p < 0.001 at 20 min, p < 0.001 at 30 min, p = 0.007 at 40 min after awakening, and p < 0.001 at leaving recovery room). No significant differences between cohort S and cohort L were detected concerning surgical outcome during 1-month-follow-up (p = 0.901 for best corrected visual acuity). Conclusion Patients undergoing DMEK with corneal abrasion suffer significant pain in the recovery room. A single dose of topic lidocaine gel reduces the early postoperative burning pain sufficiently and does not affect the surgical outcome.https://doi.org/10.1186/s12871-023-02258-yPostoperative painTopical lidocaine gelDescemet membrane endothelial keratoplastyIatrogenic corneal abrasion |
| spellingShingle | Nicolas Leister Björn Bachmann Mario Matthaei Uwe Trieschmann Christine Schumacher Vanessa Löw Bernd W. Böttiger Silvia Schrittenlocher Ludwig M. Heindl Claus Cursiefen Immediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty (DMEK) under general anaesthesia: a pilot retrospective analysis BMC Anesthesiology Postoperative pain Topical lidocaine gel Descemet membrane endothelial keratoplasty Iatrogenic corneal abrasion |
| title | Immediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty (DMEK) under general anaesthesia: a pilot retrospective analysis |
| title_full | Immediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty (DMEK) under general anaesthesia: a pilot retrospective analysis |
| title_fullStr | Immediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty (DMEK) under general anaesthesia: a pilot retrospective analysis |
| title_full_unstemmed | Immediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty (DMEK) under general anaesthesia: a pilot retrospective analysis |
| title_short | Immediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty (DMEK) under general anaesthesia: a pilot retrospective analysis |
| title_sort | immediate postoperative topical lidocaine gel for the treatment of eye pain following corneal abrasion in descemet membrane endothelial keratoplasty dmek under general anaesthesia a pilot retrospective analysis |
| topic | Postoperative pain Topical lidocaine gel Descemet membrane endothelial keratoplasty Iatrogenic corneal abrasion |
| url | https://doi.org/10.1186/s12871-023-02258-y |
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