Combination of two generic drugs, an opioid analgesic and corticosteroid, for retrobulbar anesthesia at the start of vitreoretinal surgery to manage post-surgery pain.
- Shows decrease in patient reported pain post-surgery compared to current treatment methods.
- Results in >35% decrease in oral analgesic intake post-surgery by patients.
Vitreoretinal (back of the eye) surgery is performed at rates as high as 26/100,000 people per year. It is more common in aged individuals and therefore surgery rates could climb as the overall population continues to age. Currently in the United States, 1 in 3 can expect to undergo vitreoretinal surgery at some point in their life. While positive surgical outcomes are typically high, as many as 75% of patients complain of severe pain post-surgery, typically within the first 24 hours. This pain leads to the use of oral analgesics to manage pain, which often have a wide range of side effects and increase the cost of recovery. Better pain management methods during surgery could increase patient comfort post-surgery and decrease recovery times.
Based on reports from ophthalmic surgeries, Emory clinicians showed that combining a corticosteroid anti-inflammatory drug with an opioid analgesic provides longer pain relief after vitreoretinal surgery than current methods. The combination drug treatment decreased average visual analog pain reports during the first 24 hours post-surgery from 3.8 to 1.9, and decreased oral analgesic intake of acetaminophen, hydrocodone and oxycodone by ~35, 75 and 35% respectively.
Single-masked clinical pilot study on 60 patients showed decreased patient-reported pain on visual analogue scale 24 hours after surgery. Patients receiving combination treatment also took less oral analgesics post-surgery compared to patients not receiving combination treatment.