Douleur postopératoire dans la chirurgie de décollement de rétine

Postoperative pain in retinal detachment surgery is frequent but it is often underestimated. The aim of this study was to determine the incidence of postoperative pain after retinal detachment surgery and to identify its predictive factors in a longitudinal study. We included 106 patients operated for retinal detachment surgery using an endo-ocular or exo-ocular approach with general anesthesia. Postoperative monitoring for 24 h evaluated the intensity of pain using a numerical scale. The possible predictive factors of this pain were studied: ocular antecedents, premedication, total amount of morphine used, type of surgery, duration of surgery, and vomiting. The incidence of postoperative pain was 57.5%, 56% of which was intense pain. Postoperative pain was greatest during the first 4 h. The predictive factors of this pain revealed by bivariate analysis of the data were the type of surgery and vomiting. The incidence and intensity of postoperative pain after retinal detachment surgery remain high. Pain management requires postoperative treatment of vomiting as well as the development of the endo-ocular surgery and locoregional anesthesia techniques.