Oral versus Topical Diclofenac for Pain Prevention during Panretinal Photocoagulation

Pain responses of Pascal 20 ms multi-spot and 100 ms single-spot panretinal photocoagulation: Manchester Pascal Study, MAPASS report 2

“…The type I error probability associated with this test of this null hypothesis is 0.05. A 1.5-point mean NPS difference was chosen since this represented a realistic value within the ranges of pain scores published in the literature for laser PRP studies to achieve significance 6 7 9 10…”

“…Oral acetaminophen, diazepam, diclofenac, mefenamic acid and paracetamol have all been studied 4 6 7. Entonox and intramuscular ketorolac tromethamine have also been studied pre-laser 4 8.…”

“…Entonox and intramuscular ketorolac tromethamine have also been studied pre-laser 4 8. To date, oral diclofenac has been shown to be effective in reduction of post-laser pain response 6. Randomised trials of pretreatment analgesia for PRP using pain scales report mean placebo group pain scores that range from 37.3 to 53.1 4 6 9 10.…”

“…To date, oral diclofenac has been shown to be effective in reduction of post-laser pain response 6. Randomised trials of pretreatment analgesia for PRP using pain scales report mean placebo group pain scores that range from 37.3 to 53.1 4 6 9 10. Pain scores of 31–69 fall within the moderate range of pain 11…”

Metamizole versus placebo for panretinal photocoagulation pain control: a prospective double-masked randomized controlled study

“…Previous studies show that 73 % of the patients submitted to PRP report painful sensation during the laser treatment [6–8]. Different strategies have been tried to relieve the level of pain associated with the procedure, such as peribulbar anesthesia [6, 9, 10], oral [11] and topical diclofenac [12], oral diazepam, oral mephenamic acid, oral acetaminophen or intramuscular ketorolac tromethamine [6], but there is no solid consensus or good evidence of the efficacy for any of them [13]. …”