유리체강 내 주사 시 주사 방향에 따른 통증 차이
Relationship between Pain and Injection Site during Intravitreal Injection
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초록
목적: 시각 척도를 이용하여 유리체강 내 주사 시 주사 부위에 따른 환자가 느끼는 통증을 비교하였다. 대상과 방법: 나이관련 황반변성, 당뇨망막병증, 망막정맥폐쇄, 중심맥락망막병증 환자 171안을 대상으로 난수표를 이용하여 주사를 시행할 해부학적 사분역을 설정한 후 bevacizumab, aflibercept, ranibizumab, dexamethasone의 유리체강 내 주사를 시행하였다. 주사 후 15분 뒤 환자에게 통증 정도를 0 (통증 없음)에서 10 (견딜 수 없을 정도의 통증) 정도까지 시각 척도를 사용하여 설문 조사를 시행하였다. 결과: 시각척도에 따른 통증 점수는 상이측 주사 시 평균 통증은 3.20점, 상비측 주사 시 3.03점, 하이측 주사 시 2.35점으로 하이측주사 시 통증이 가장 적었다(p=0.012). 결론: 유리체강 내 주사 시 안구 하이측에 주사를 시행하는 것이 환자의 통증을 줄이는 데 도움을 줄 수 있다.
Abstract
Purpose: Using a visual analogue scale, patients pain was compared according to injection site during intravitreal injection. Methods: A prospective, clinical trial was conducted on 171 eyes of patients experiencing age-related macular degeneration, diabetic retinopathy, retinal vein occlusion, or central serous chorioretinopathy. After determining the anatomic quadrant of the injection site, patients were randomized to receive intravitreal bevacizumab, aflibercept, ranibizumab, or dexamethasone injection. Fifteen minutes after the injection, patients completed a survey about pain using a visual analogue scale from 0 (no pain) to 10 (unbearable pain). Results: According to the visual analogue scale, pain score was 3.20 at the superotemporal site, 3.03 at the superonasal site, and 2.35 at the inferonasal site. Pain was lowest when injected in an inferotemporal site (p = 0.012). Conclusions: Intravitreal injection at an inferotemporal site can help reduce patient pain.
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