The added effect of preoperative nepafenac on pain and discomfort following alcohol-assisted photorefractive keratectomy.
Purpose: To evaluate the effect of preoperative nepafenac on pain following alcohol-assisted photorefractive keratectomy (PRK). Settings: Tel-Aviv Sourasky Medical Center—a tertiary medical center. Design: Observational case-series. Methods: Setting : Refractive center. Study Population : 205 PRK pa...
| Publicado en: | Therapeutic Advances in Ophthalmology pp. 1 - 12 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
6/24/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=186160809&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 186160809 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 25158414 LAW0 jtl: Therapeutic Advances in Ophthalmology issn: 25158414 maglogo: Y pubinfo: dt: 6/24/2025 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 186160809 186160809 186160809 10.1177/25158414251349340 186160809 ppf: 1 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The added effect of preoperative nepafenac on pain and discomfort following alcohol-assisted photorefractive keratectomy. aug: au: Levinger, Eliya Gomel, Nir Hirsh, Ami Tenne, Maya Achiron, Asaf Levinger, Nadav Levinger, Shmuel Shemesh, Nadav Abulafia, Adi Mimouni, Michael Sorkin, Nir affil: Conceptualization, Department of Ophthalmology, Tel-Aviv Medical Center, Weizzman 6, Tel Aviv 6423906 Israel Enaim Medical Center, Tel-Aviv, Israel sug: subj: Premedication Antiinflammatory Agents, Non-Steroidal Therapeutic Use Ophthalmic Solutions Therapeutic Use Pain Management Keratectomy, Photorefractive Human Female Male Adult Nonexperimental Studies Retrospective Design Sample Size Determination Questionnaires Acetaminophen Administration and Dosage Oxycodone Administration and Dosage Naloxone Administration and Dosage Photophobia Visual Acuity Nausea and Vomiting Visual Analog Scaling Kruskal-Wallis Test Repeated Measures Analysis of Variance Analysis of Covariance Spearman's Rank Correlation Coefficient Univariate Statistics Data Analysis Software Descriptive Statistics Adult: 19-44 years Female Male ab: Purpose: To evaluate the effect of preoperative nepafenac on pain following alcohol-assisted photorefractive keratectomy (PRK). Settings: Tel-Aviv Sourasky Medical Center—a tertiary medical center. Design: Observational case-series. Methods: Setting : Refractive center. Study Population : 205 PRK patients grouped randomly into five according to pain-management protocols: (1) paracetamol/ibuprofen (Parac-Ibupr group, n = 39), (2) high-dose oxycodone/naloxone only (Oxy-only group, n = 45), (3) oxycodone/naloxone and postoperative 0.1%-nepafenac (Oxy-Nep group, n = 36), (4) oxycodone/naloxone and preoperative and postoperative 0.1%-nepafenac (Nep-Oxy-Nep group, n = 42), and (5) preoperative and postoperative 0.1%-nepafenac only (Nep-only group, n = 43). Preoperative nepafenac was administered three times daily for 2 days. Main Outcome Measures : Mean and maximal pain levels (postop days 1–5), duration of tearing/photophobia, number of pain tablets taken, uncorrected visual acuity (UCVA), side effects and epithelial healing delay. Results: Mean pain scores differed significantly between groups (p < 0.001)—lowest in groups receiving preop nepafenac (Nep-only: 1.8 ± 1.6, Nep-Oxy-Nep: 2.3 ± 1.5) compared to the Oxy-Nep (3.2 ± 1.9), Oxy-only (3.8 ± 1.7), and Parac-Ibupr (4.8 ± 1.6) groups. Similar findings were observed with maximal pain scores. Total number of pain tablets taken was lowest in the Nep-only group. Duration of photophobia was shortest in groups receiving preoperative nepafenac (p < 0.001). Duration of tearing was longest in the Parac-Ibupr group (p < 0.001). Nausea/vomiting occurred in 20% of the Oxy-only group (p < 0.001). There were four cases of delayed epithelial healing—all in groups not treated with nepafenac. One-month UCVA did not differ between groups. No additional independent factors were found to be associated with pain except age. Conclusion: Adding preoperative nepafenac significantly reduced pain and photophobia with complete epithelial healing. Addition of oral opiates to nepafenac treatment had little analgetic benefit. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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