Assessment of Patient Pain Experience during Intravitreal 27-Gauge Bevacizumab and 30-Gauge Ranibizumab Injection.
10.3341/kjo.2015.29.3.190
- Author:
Mete GULER
1
;
Burak BILGIN
;
Musa CAPKIN
;
Ali SIMSEK
;
Semsettin BILAK
Author Information
1. Department of Ophthalmology, Adiyaman University School of Medicine, Adiyaman, Turkey. meteglr@yahoo.com
- Publication Type:Comparative Study ; Original Article
- Keywords:
Bevacizumab;
Intravitreal injections;
Pain;
Ranibizumab;
Visual analogue scale
- MeSH:
Aged;
Aged, 80 and over;
Angiogenesis Inhibitors/*administration & dosage;
Antibodies, Monoclonal, Humanized/*administration & dosage;
Bevacizumab/*administration & dosage;
Diabetic Retinopathy/drug therapy/physiopathology;
Female;
Humans;
*Intravitreal Injections;
Macular Degeneration/drug therapy/physiopathology;
Macular Edema/drug therapy/physiopathology;
Male;
Middle Aged;
Pain Measurement;
Ranibizumab/*administration & dosage;
Retinal Vein Occlusion/drug therapy/physiopathology
- From:Korean Journal of Ophthalmology
2015;29(3):190-194
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To compare pain scores of patients during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection procedures. METHODS: Seventy eyes of 70 patients who had not previously undergone intravitreal anti-vascular endothelial growth factor therapy were included in this study. Thirty-five patients received ranibizumab and 35 patients received bevacizumab. The diagnoses of the patients were: 27 age related macular degeneration, 15 diabetic macular edema, 9 diabetic vitreous hemorrhage, 6 central retinal vein occlusion, 11 branch retinal vein occlusion and 2 central serous chorioretinopathy. Bevacizumab (1.25 mg/0.05 mL) was injected into the vitreous cavity using a 27-gauge needle, and ranibizumab (0.5 mg/0.05 mL) was injected with 30-gauge needle. Patients were asked just after the injection to rate their perceived pain during the injection using the visual analogue scale (VAS) of 0 (no pain) to 10 (unbearable/worst pain). The average of these scores was used as the primary outcome. RESULTS: The VAS pain scores in the ranibizumab and bevacizumab groups were 1.06 +/- 0.91 (range, 0 to 3) and 1.94 +/- 1.55 (range, 0 to 7), respectively, a significant difference (p = 0.005). Patients <65 and > or =65 years of age in both the ranibizumab and bevacizumab groups were then compared. For patients <65, there was a significant difference in the average VAS pain scores between groups (p = 0.003). However, for patients > or =65 years, there was not a significant difference in the average VAS pain scores between groups (p = 0.238). Female and male patients in both ranibizumab and bevacizumab groups were also compared. For female patients, there was a significant difference in the average VAS pain scores between groups (p = 0.016), although not for male patients (p = 0.078). CONCLUSIONS: Thirty-gauge intravitreal injection is more comfortable than 27-gauge injection. Injection of bevacizumab with 30-gauge needle syringes may be more tolerable for patients.
