Oral acetaminophen (paracetamol) for additional analgesia in phacoemulsification cataract surgery performed using topical anesthesia: Randomized double-masked placebo-controlled trial
Presented at the XXVI Congress of the European Society of Cataract & Refractive Surgeons, Berlin, Germany, September 2008.
Received 2 July 2009; received in revised form 24 September 2009; accepted 25 September 2009.
Purpose
To evaluate the clinical analgesic efficacy of 1.0 g oral acetaminophen (paracetamol) given in addition to topical anesthesia before phacoemulsification cataract surgery.
Setting
Inpatient and outpatient ophthalmology clinics, Bydgoszcz, Poland.
Methods
Consecutive patients with age-related cataract having phacoemulsification under topical anesthesia (tetracaine 0.5%) were enrolled in a prospective double-blind randomized placebo-controlled study. Patients were randomly assigned to preoperative oral administration of a placebo medication or to oral administration of 1.0 g acetaminophen. The main outcome measure was intensity of pain during and after surgery. Pain intensity was measured using a 10 cm baseline visual analog scale and a discrete 5-category verbal rating scale.
Results
The study comprised 160 consecutive patients (80 in each group). Intraoperatively, the mean visual analog scale pain intensity score was 2.17 ± 1.81 in the placebo group and 1.45 ± 1.17 in the acetaminophen group and the mean verbal rating scale score, 1.11 ± 0.73 and 0.67 ± 0.66, respectively (P<.01). Postoperatively, the mean visual analog scale score for pain was 1.47 ± 1.39 in the placebo group and 0.56 ± 0.61 in the acetaminophen group and the mean verbal rating scale score, 0.94 ± 0.79 and 0.28 ± 0.41, respectively (P<.01). There was no significant difference in patient behavior during surgery and no significant adverse effects of acetaminophen use.
Conclusion
Preoperative oral administration of acetaminophen 1.0 g was effective, convenient, safe, and cost effective in reducing intraoperative and postoperative pain in phacoemulsification performed using topical anesthesia.
Financial Disclosure
No author has a financial or proprietary interest in any material or method mentioned.
From the Department of Ophthalmology (B.J. Kaluzny, J.J. Kaluzny, Kazmierczak, Laudencka) Collegium Medicum, Nicolas Copernicus University, Oftalmika Eye Hospital (B.J. Kaluzny, J.J. Kaluzny, Eliks), and Eskulap Hospital (Eliks), Bydgoszcz, Poland
Corresponding author: Bartlomiej J. Kaluzny, MD, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Curie-Sklodowskiej 9, 85-094 Bydgoszcz, Poland.
ABSTRACT