Abstract
Purpose To compare and quantify the degree of post-operative pain experienced by patients undergoing primary and secondary hydroxyapatite orbital implantation.
Methods A prospective survey design was employed to monitor patients' pain pre-operatively and up to 7 days post-operatively. Fifty-five consecutive patients undergoing primary and secondary hydroxyapatite orbital implantation were recruited over a period of 1 year. Standardised anaesthetic, operative and post-operative protocols were followed. During the patients' in-patient stay nurses completed a data proforma that required them to record patients' pain using an 11-item numerical rating scale. A self-completion proforma was given to patients to score their pain at home until the first post-operative outpatient appointment.
Results Patients undergoing primary implant surgery tend to experience more post-operative pain than those undergoing secondary implant surgery. A small proportion of patients experience severe post-operative pain.
Conclusion Post-operative pain experienced by patients undergoing primary and secondary hydroxyapatite implantation has been underestimated. This study has provided the necessary data to enable such patients to be effectively counselled pre-operatively and to plan a rational discharge policy.
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References
Cowper TR . Hydroxyapatite motility implants in ocular prosthetics. J Prosthetic Dentistry 1995;73:267–73.
Dutton JJ . Coralline hydroxyapatite as an ocular implant. Ophthalmology 1991;98:370–7.
Ashworth J, Rhatigan M, Sampath R, Brammer R, Sunderland S, Leatherbarrow B . The hydroxyapatite orbital implant: a prospective study. Eye 1996;10:29–37.
Oestricher JH, Lui E, Berkowitz M . Complications of hydroxyapatite orbital implants. Ophthalmology 1997;104:324–9.
Shields CL, Shields JA, De Potter P, Singh AD . Problems with the hydroxyapatite orbital implant: experience with 250 consecutive cases. Br J Ophthalmol 1994;78:702–6.
Jensen MP, Karoly P, O'Riordan EF, Bland F, Burns RS . The subjective experience of acute pain. Clin J Pain 1989;5:153–9.
Waterman H, Grabham J, Obanye G . The incidence of pain in post-operative ophthalmic patients. Ophthalmic Nursing 1997;2:4–10.
Osborne GA, Rudkin GE . Outcome after day-case surgery in a major teaching hospital. Anaesth Intens Care 1993;21:822–7.
VandenBerg AA, Lambourne A, Yazji NS, Laghari NH . Vomiting after ophthalmic surgery. Anaesthesia 1987;42:270–6.
Van den Berg AA, Lambourne A, Clyburn PA . The oculo-emetic reflex. Anaesthesia 1989;44:110–7.
Oates JD, Snowdon SL, Jayson DW . Failure of pain relief after surgery. Anaesthesia 1994;49:755–8.
Tittle M, McMillan S . Pain and pain-related side-effects in an ICU and on a surgical unit: nurses' management. Am J Crit Care 1994;3:25–30.
Seers K . Patients' perceptions of acute pain. In: Wilson-Barnett J, Robinson S, editors. Directions in nursing research. London: Scutari, 19:Chap 12.
Massry GG, Holds JB . Complications of hydroxyapatite orbital implant. Ophthalmology 1997;104:1368–9.
Andrews PL . Physiology of nausea and vomiting. Br J Anaesth 1992;69(Suppl 1):s2–19.
Kenny GN . Risk factors for post-operative nausea and vomiting. Anaesthesia 1994;49(Suppl):6–10.
Watcha MF, White PF . Post-operative nausea and vomiting. Anesthesiology 1992;77:162–84.
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Waterman, H., Leatherbarrow, B., Slater, R. et al. The hydroxyapatite orbital implant: Post-operative pain. Eye 12, 996–1000 (1998). https://doi.org/10.1038/eye.1998.256
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DOI: https://doi.org/10.1038/eye.1998.256