유리체강내 주사 시 바늘 직경 차이에 따른 안구 통증 비교
Ocular Pain According to Needle Diameter during Intravitreal Injection
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목적: 유리체강내 주사 시 주삿바늘 직경에 따른 안구 통증 및 주사 시간을 비교하고자 하였다. 대상과 방법: 본 연구는 이전에 유리체강내 주사를 받은 적이 없는 환자를 대상으로 전향적으로 실시하였다. 환자를 무작위 배정하여 30게이지(30G Group)와 40게이지(40G Group) 바늘을 이용하여 유리체강내 주사를 시행하였고, 약제로는 Bevacizumab, Ranibizumab, Aflibercept를 사용하였다. 유리체강내 주사 시간은 주삿바늘이 결막에 접촉하는 시점부터 바늘 제거 후 지혈을 마친 순간까지로 정의하였고, 안구 통증은 주사를 맞은 직후 환자들에게 0점(통증 없음)부터 10점(참을 수 없는 고통)까지의 visual analogue scale (VAS) 척도로 설문조사를 하여 평가하였다. 결과: 총 60명 60안이 연구에 포함되었고 30G Group, 40G Group에 각각 30명의 환자가 배정되었다. 유리체강내 주사 시간은 30G Group에서 42.00 ± 37.18초, 40G Group에서 32.73 ± 14.58초로 측정되었으나, 두 군 간의 유의한 차이를 보이지는 않았다(p=0.212). VAS 척도에 따른 통증 점수는 30G Group, 40G Group 각각 3.50 ± 1.25점, 2.87 ± 1.01점으로 두 군 간의 유의한 차이가 있었다(p=0.035). 결론: 유리체강내 주사 시 40G 바늘을 사용하는 것이 30G 바늘을 사용하는 것보다 환자의 안구 통증을 줄일 수 있었다.
Abstract
Purpose: To compare the ocular pain scores and injection times of patients during 30 and 40-gauge intravitreal injection procedures. Methods: This study was performed prospectively in patients who had not previously received intravitreal injection. Patients were randomly divided into two groups and intravitreal injections of bevacizumab, ranibizumab, and aflibercept were performed using a 30-gauge needle (30G Group) or a 40-gauge needle (40G group). The injection time defined as the time between conjunctival touching of the needle and finishing the hemostasis after needle removal was measured in each patient. Immediately after the injection, patients were asked to rate their pain level during the injection using a visual analogue scale (0, no pain; 10, unbearable pain). Results: Sixty eyes of 60 patients were included in this study and 30 patients were assigned to each group. The mean injection times of the 30G and 40G groups were 42.00 ± 37.18 and 32.73 ± 14.58 seconds, respectively, with no significant difference (p = 0.212). The visual analogue scale, pain scores in the 30G and 40G groups were 3.50 ± 1.25 and 2.87 ± 1.01, respectively, with a significant difference (p = 0.035). Conclusions: Intravitreal injection with a 40-gauge needle was less painful than that with a 30-gauge needle.
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