| Abstract | Cilj istraživanja: Cilj ovog istraživanja je bio utvrditi postoji li značajna razlika u subjektivnom osjetu boli prilikom davanja intravitrealne injekcije ako se pacijentima umjesto postavljanja blefarostata, vjeđe rastvaraju i pridržavaju prstima.
Ispitanici i metode: U prospektivnom kohortnom istraživanju provedenom u Kliničkom bolničkom centru Split, na Klinici za očne bolesti, uključeni su bolesnici na redovnom režimu primanja intravitrealne terapije lijeka Avastin. Istraživanje se provodilo od kolovoza 2019. godine do siječnja 2020. godine. U istraživanju je sudjelovalo 90 bolesnika. Prije svakog zahvata, ispitanici su ispunjavali upitnik anksioznosti kao stanja i osobine ličnosti (eng. state-trait anxiety inventory for adults, STAI) i ljestvicu pretjeranog doživljavanja ozbiljnosti boli (eng. pain catastrophizing scale, PCS). Na početku samog zahvata, provedena je dezinfekcija kože oko oka, vjeđa i površine oka 5%-tnim povidon jodidom te lokalna anestezija, pri čemu je korišten topički 0,4% oksibuprokain klorid. Za povlačenje vjeđa kod ispitanika kontrolne skupine primjenjen je sterilni blefarostat, a kod ispitanika eksperimentalne skupine vjeđe za razdvajanje vjeđa koristili su se prsti. Intravitrealno se primijenjivao lijek Avastin u dozi od 1,25mg/0,05ml. U istraživanju je dano sveukupno 174 injekcija u 90 bolesnika. Nakon zahvata ispitanici su kvantificirali jačinu boli na numeričkoj skali (NRS).
Rezultati: U istraživanju je dano 174 injekcija u 90 bolesnika, 73 injekcije (41,95%) u žena i 101 (58,05%) u muškaraca. Dvadeset i sedam (15,52%) bolesnika dobili su po jednu injekciju, četrdeset i pet (51,72%) po dvije, petnaest (25,86%) po tri i tri (6,90%) bolesnika po četiri intravitrealne injekcije lijeka Avastin. Nije utvrđena statistički značajna razlika (P=0,996) po spolu između eksperimentalne i kontrolne skupine. Prema dobivenim rezultatima za PCS ukupno i STAI, nije pronađena statistički značajna razlika (P=0,164; P=0,767) između skupina, ali su se statistički značajno razlikovale prema dobivenim rezultatima za NRS (P=0,033). Dobiveni je NRS rezultat za kontrolnu skupinu iznosio 2,86±2,51, a za eksperimentalnu skupinu 2,09±2,18. Pronađena je blaga pozitivna korelacija (r=0,386) između STAI upitnika i PCS ljestvice. Nije pronađena korelacija između STAI upitnika i NRS ljestvice (r=0,156) te između PCS i NRS ljestvice (r=0,141).
Zaključci: Iz rezultata ovog istraživanja možemo zaključiti da korištenje prstiju za razdvajanje vjeđa umjesto blefarostata značajno smanjuje osjećaj boli prilikom davanja intravitrealne injekcije. Spol nema utjecaja na doživljaj boli. Postoji blaga pozitivna korelacija između STAI upitnika i PCS ljestvice te ne postoji korelacija između STAI upitnika i NRS te između PCS i NRS ljestvice. |
| Abstract (english) | Objectives: The aim of this study was to determine whether there is a statistically significant difference in the subjective experience of pain when implementig bimanual lid retraction versus metal speculum eyelid retraction in intravitreal injection
Subjects and Methods: This prospective cohort study, conducted at the Clinic for Ophthalmology of University Hospital of Split, included patients treated with intravitreal Avastin. The study was conducted between August 2019 and January 2020. Ninety patients participated in the study. Before each procedure, patients completed a STAI (state-trait anxiety inventory for adults) and PCS (pain catastrophizing scale) questionnaires. At the beginning of the procedure, subjects underwent disinfection using 5% PVI on the skin around eye, eyelids and ocular surface and local anaesthesia with topical 0,4% oxyburocaine hydrochloride. In the control group, the metal speculum lid retraction technique was used, and in experimental group, a bimanual lid retraction technique was. Further, the study applied an intravitreal Avastin in the dose of 1,25mg/0,05ml. 174 injections in 90 patients were given in the study. After the procedure, subjects reported pain intensity using the numerical scale (NRS).
Results: 174 injections in 90 patients were given in the study, 73 (41,95%) injections in women and 101 (58,05%) in men. Twenty-seven (15,52%) patients received one injection, forty-five (51,72%) patients received two injections, fifteen (25,86%) patients received three injections and three (6,90%) patients received four intravitreal injection of Avastin. There was no statistically significant difference (P=0,996) based on gender between experimental and control group. According to the obtained results for PCS total score and STAI, there was no statistically significant difference (P=0,164; P=0,767) between group, but there was statistically significant difference (P=0,033) between group according to the obtained results for NRS. The obtained NRS result for the control group was 2.86 ± 2.51, and for the experimental group 2.09 ± 2.18. There was a slight positive correlation (r=0,386) between STAI and PCS. There was no correlation between STAI and NRS (r=0,156) and between PCS and NRS (r=0,141).
Conclusion: From the obtained data we can conclude that the use of bimanual lid retraction significantly reduces the feeling of pain during the intravitreal injection procedure. Gender did not affect the experience of pain. There was a slight positive correlation between STAI and PCS. There was no correlation between STAI and NRS and between PCS and NRS. |
