表面麻醉下白内障手术患者的时间感知和疼痛评分及术后满意度的关系

Relationships of pain assessment with time perception and satisfaction for cataract surgeries in patients under topical anesthesia

目的：研究表面麻醉下白内障手术患者的时间感知、疼痛评分和术后满意度的关系。 方法：纳入白内障手术患者90例90眼的手术病例,使用视觉模拟评分法（ visual analogue scales,VAS）评估术中疼痛。根据VAS结果为0分,1~3分,〉3分,分别分成玉级疼痛组,Ⅱ级疼痛组和芋级疼痛组,比较组间的年龄、性别、眼别,以及手术时长客观值、主观值和术后满意度。结果：三组不同疼痛评分组之间的年龄、性别和眼别都没有统计学意义上的差异（P〉0.05）。疼痛评分越高的手术病例实际的手术时间比较长（P〈0.05）,疼痛评分越高的手术病例患者感知的手术时间也比较长（P〈0.05）,玉级疼痛组和Ⅱ级疼痛组的患者能够准确的感知手术时长,而芋级疼痛组的患者已无法准确感知手术时长,疼痛评分越高的手术病例患者认为手术不成功的比例较多（P〈0.05）。 结论：表面麻醉下白内障手术患者的时间感知准确性和对手术效果的评价随着术中疼痛的加重而下降,因此,让患者了解到疼痛不能作为判断手术是否成功的一个指标是术前访视及宣教的重点。

AIM： To investigate the relationships of pain assessment with time perception and satisfaction for cataract surgeries in patients under topical anesthesia. METHODS： Ninety patients with 90 eyes received cataract surgeries were included. Pain in surgery was assessed by using Visual Analogue Scales （ VAS ） . According to VAS results, the patients were classified into three groups： Level-I pain group （ VAS：0 score ） , level-II pain group （ VAS：1 ~3 scores ） , level-Ⅲ pain group （ VAS：〉3 scores ） . The differences of the three groups on age, sex, laterality, objective duration of the operations, subjective duration and satisfaction for the surgeries were analyzed. RESULTS： No statistically significant differences between every two groups on age, sex and laterality were detected （P〉0. 05）. The actual operation time and subjective duration was relatively long in the surgery examples with higher pain scores（P〈0. 05）. The patients in Level - I and level - II pain group can accurately perceive the duration of their surgery, while those in level-Ⅲ pain group can not accurately perceive. The higher pain scores the patients had, the lower proportion of successful operation was（P〈0. 05）. CONCLUSION：The accuracy of time perception and satisfaction for surgeries decreased with the aggravation of intraoperative pain in patients under topicalanesthesia. So it is an important part of preoperative education and visits to let the patients understand that the feeling of pain cannot be used as a judgment whether the cataract surgery is successful.