Effects of Diclofenac Drops and Artificial Tear Drops on Pain Reduction after Cataract Surgery: A Comparative Study

Background: This study aimed to compare the impacts of applying diclofenac drops and artificial tear drops before cataract surgery on decreasing pain after the operation. Methods: This double-blind randomized clinical trial study was conducted patients who referred to Feiz Hospital (Isfahan, Iran) for cataract surgery during 2011-12. The participants were divided into two groups of 44 people to receive either diclofenac drops or artificial tear drops before the operation. Patients' age, sex, weight, and pain severity, as well as the surgeon's satisfaction, sedative drug dosage during and after the surgery, and the complications after the operation were recorded. Pain intensity was evaluated by a visual analogue scale (VAS). The American Society of Anesthesiologists (ASA) scores were also recorded. Chi-square, Mann-Whitney U, and student's-t tests along with stratified regression were used to analyze the collected data. Findings: Among the total number of 88 studied patients, 33% were males. Their mean age was 64.8 years. The ASA score in all patients was 1.6. Diclofenac drops and artificial tear drops were not significantly different in reducing pain during or after the surgery. No significant differences were observed between the two groups in most of the other measured variables. However, the dosage of ketamine during the surgery and the ASA scores were lower in patients who had received diclofenac drops compared to those who had received artificial tear drops.   Conclusion: Based on the results of this study, diclofenac drops and artificial tear drops were not significantly different in reducing pain after cataract surgery. Moreover, the surgeon's satisfaction during surgery from the patient's cooperation was at the same level in both groups. It is worth mentioning that diclofenac drops were more effective on reducing the dosage of ketamine during the surgery. Since ketamine is an anesthetic with analgesic properties, the lower need to ketamine in the diclofenac group implies the effects of the drug on reducing pain during surgery. However, the two kinds of drops had no significantly different impacts on the dosage of consumed drugs during the surgery and in the recovery room. Keywords: Diclofenac, Tear drops, Cataract, Visual analogue scale