Analgesic effect of topical sodium diclofenac 0.1% drops during retinal laser photocoagulation

Aims-To evaluate the analgesic effect of topical sodium diclofenac 0.1% dur ing retinal laser photocoagulation. Methods-87 patients, 45 with proliferative diabetic retinopathy treated wit h two sessions of panretinal photocoagulation (group A), and 42 patients wi th nonproliferative diabetic retinopathy who underwent grid treatment of th e posterior pole (19 bilaterally) (group B). Sodium diclofenac 0.1% or sodi um chloride 0.9% drops were topically applied 30-135 minutes before laser t reatment in a masked fashion. Patients who had two sessions were given the alternate drug in the second one. Pain level was evaluated immediately afte r laser treatment with the visual analogue scale (VAS). The results were st atistically analysed. Results-Patients in group A reported pain in 85/90 sessions (94%). The aver age pain level was 44.2% with sodium diclofenac 0.1% drops and 53.1% with s odium chloride 0.9% drops (p = 0.011 by paired t test). Patients in group B reported pain in only 16/60 sessions (26.7%), and the pain level ranged fr om 10% to 60% regardless of the kind of drops used. There was no correlatio n in either group between level of pain and time interval from application of the drops to laser treatment (30-135 minutes) or average energy level us ed (100-500 mW). Conclusion-Sodium diclofenac 0.1% is useful for pain reduction and should b e applied before panretinal photocoagulation.