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KMID : 0213520150290030190
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Korean Journal of Ophthalmology
2015 Volume.29 No. 3 p.190 ~ p.194
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Assessment of Patient Pain Experience during Intravitreal 27-Gauge Bevacizumab and 30-Gauge Ranibizumab Injection
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Guler Mete
Bilgin Burak
Capkin Musa
Simsek Ali
Bilak Semsettin
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Abstract
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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 ≥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 ≥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.
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KEYWORD
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Bevacizumab, Intravitreal injections, Pain, Ranibizumab, Visual analogue scale
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