Does office-based flexible cystoscopy provide better pain perception than rigid cystoscopy: a systematic review and meta- analysis

Abstract Background: This systematic review aimed to compare the pain discomfort levels between InvisalignⓇ aligners comparing with traditional fixed appliances at multiple time points, through Pain Visual Analog Scale (VAS). Methods: Four electronic databases (Pubmed, Medline, CENTRAL and Scholar) were searched up to February 2019. There were no restrictions on year and publication status. Randomized clinical trials (RCTs) and case-control studies comparing pain perception through VAS in patients treated with Invisalign aligners and with labial appliances were included. Risk of bias within and across studies was assessed using Cochrane tool and Newcastle-Ottawa Scale (NOS) approach. Random-effects meta-analysis were conducted. VAS score at 1, 3 and 7 days, and analgesic consumption was collected. Pairwise and Binary Random-Effects Meta-analyses were used to synthesize available data. Results: At the initial search, a total of 87 articles were retrieved. Following the review protocol, 4 articles met the inclusion criteria and were included, with a total of 214 participants (139 females, 75 males). All studies were considered of high methodological quality. The results demonstrate that Invisalign aligners seems to be associated with significantly less pain than fixed appliances at 7 days after beginning the orthodontic treatment, although at 1 and 3 days the pain experience was similar in both orthodontics appliances. In regard to the type of material, SmartTrackⓇ aligners appear to give significantly better comfort for orthodontic patients than previous standard material, being that 3 days after appliance’s insertion this pain differential becomes significant, and this difference is more pronounced at 7 days. Conclusion: Patients treated with Invisalign experience less pain discomfort than those treated with fixed appliances and consume less analgesics. Overall, Invisalign promotes better pain and discomfort experience for the patient in the course of orthodontic treatment. Larger RCTs are needed to definitely demonstrate these findings throughout the orthodontic treatment.

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Pain Perception of the First Eye versus the Second Eye during Phacoemulsification under Local Anesthesia for Patients Going through Cataract Surgery: A Systematic Review and Meta-Analysis

Journal of Ophthalmology ◽

10.1155/2019/4106893 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Chuying Shi ◽

Jinqiu Yuan ◽

Benny Zee

Keyword(s):

Systematic Review ◽

Cataract Surgery ◽

Local Anesthesia ◽

Fixed Effects ◽

Pain Perception ◽

Meta Analysis ◽

Major Surgery ◽

Eye Surgery ◽

Pain Scores ◽

The Difference

Background. Phacoemulsification under local anesthesia is regarded as the major surgery for cataract treatment. Recent research has compared the pain perception between the first eye and the second eye during phacoemulsification. However, these studies have also yielded controversial findings. Consequently, we performed a systematic review and a meta-analysis to investigate the difference in the pain perception between the first and second eyes during phacoemulsification. Method. We searched the PubMed, EMBASE, and Cochrane CENTRAL databases for the studies published up to October 5, 2018. Prospective observational studies were included. The meta-analysis was conducted by means of random-effects model and fixed-effects model according to the heterogeneity. Evaluation of the methodological quality of studies was based on Newcastle-Ottawa Scale (NOS). Results. Overall, eight studies were included in the meta-analysis. The analysis of pooled data showed that the pain scores of the first eye shortly after surgery under local anesthesia were significantly lower as compared to the second eye (WMD: 0.69; 95% CI: 0.40, 0.98; P<0.00001). The average pain scores of the first eye shortly after surgery under the topical anesthesia were also lower than those of the second eye (WMD: 1.08; 95% CI: 0.79, 1.36; P<0.00001). Conversely, anxiety scores in the first eye surgery were significantly higher than those in the second eye surgery (SMD: −0.40; 95% CI: −0.64, −0.16; P=0.001). However, the difference of the pain scores accessed on the first postoperative day between the first and second eye surgeries (WMD: −0.05; 95% CI −0.40, 0.31; P=0.79) as well as cooperation grades of patients between the first and second eye surgeries (WMD: 0.35; 95% CI −0.07, 0.76; P=0.10) was not statistically significant. Conclusion. Patients experienced more pain in the surgery of the second eye than that of the first eye, which probably related to lower anxiety before the second surgery. It suggests that we should consider preoperative intervention to reduce the perceived pain during second eye cataract surgery.

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