Table 2 Pain in the included studies according to Jensen’s classification [8]
From: Patient pain during intravitreal injections under topical anesthesia: a systematic review
References (country) | Groups according to anesthetic method | Difference in pain | Mean pain score related to discomfort of anesthesia | Mean pain score during injection | Mean global pain | Jensen’s classification |
|---|---|---|---|---|---|---|
Blaha et al. [16] (USA) | G1: 0.5% topical proparacaine | NS | G1: 14 | G1: 30 | G1: 44 | G1: MI |
G2: 0.5% topical tetracaine | G2: 7 | G2: 28 | G2: 35 | G2: MI | ||
G3: topical proparacaine + 4% lidocaine pledget | G3: 16 | G3: 23 | G3: 39 | G3: MI | ||
G4: topical proparacaine + SC injection of 2% lidocaine | G4: 10 p = 0.17 (NS) | G4: 31 p = 0.28 (NS) | G4: 41 p = 0.65 (NS) | G4: MI | ||
Yau et al. [11] (Canada) | G1: 0.5% tetracaine hydrochloride drops + 4% lidocaine pledget for 10 | NS | NA | G1: 19 | NA | G1: MI |
G2: 0.5% tetracaine hydrochloride drops | G2: 21 | G2: MI | ||||
G3: 4% cocaine + epinephrine 1/100.000 drops | G3: 21 | G3: MI | ||||
Örnek et al. [14] (Turkey) | G1: 0.75% levobupivacaine drops | Statistically different, but not clinically significant | NA | G1: 44.77 | NA | G1: MI |
G2: 0.5% proparacaine drops | G2: 34.18 p = 0.003 | G2: MI | ||||
Shiroma et al. [1] (Brazil) | G1: 2% lidocaine gel | NS | G1: 0 | G1: 26.3 ± 16.8 | G1: 26.3 | G1: MI |
G2: 3.5% lidocaine gel | G2: 0 | G2: 20.8 ± 13.5 | G2: 20.8 | G2: MI | ||
G3: 5% lidocaine gel | G3: 0 | G3: 20.0 ± 16.5 | G3: 20.0 | G3: MI | ||
G4: 8% lidocaine gel | G4: 0 | G4: 19.3 ± 14.0 | G4: 19.3 | G4: MI | ||
G5: 12% lidocaine gel | G5: 0 | G5: 18.3 ± 13.5 | G5: 18.3 | G5: MI | ||
Andrade et al. [6] (Brazil) | G1: proparacaine | SC injection of 2% lidocaine was most effective, with clinical significance (>12 mm) | NA | G1: 32 ± 17 | NA | G1: MI |
G2: proparacaine + SC injection of 2% lidocaine | G2: 10 ± 10 | G2: MI | ||||
G3: 2% lidocaine gel | G3: 10 ± 11 p = 0.02 | G3: MI | ||||
Kumar et al. [15] (UK) | G1: 0.5% proximetacaine | NS | G1: 6.0 ± 0.63 | G1: 8.7 ± 0.83 | G1: 14.7 | G1: MI |
G2: SC injection of 2% lidocaine | G2: 6.0 ± 0.96 | G2: 9.3 ± 0.96 p = 0.84 | G2: 15.3 | G2: MI | ||
Davis et al. [2] (USA) | GA: 0.5% topical proparacaine | NS | NA | G1: 17.8 ± 14.4 | NA | G1: MI |
GB: topical proparacaine + 4% lidocaine pledget | G2: 17.5 ± 14.6 | G2: MI | ||||
GC: 3.5% lidocaine gel | G3: 14.8 ± 15.8 p = 0.38 | G3: MI | ||||
Rifkin and Schaal [5] (USA) | G1: 0.5% TetraVisc | Statistically different, but not clinically significant | NA | G1: 33.9 ± 22.6 | NA | G1: MI |
G2: proparacaine | G2: 31.7 ± 21.8 | G2: MI | ||||
G3: tetracaine | G3: 30.5 ± 20.1 p < 0.01 | G3: MI |