目的：探讨影响白内障患者超声乳化术中疼痛的相关危险因素。

方法：回顾性病例对照研究。连续纳入2023-12/2024-01于郑州大学第一附属医院诊断为白内障的患者62例62眼，患者于术后5 min内使用数字评定量表进行术中疼痛评估，手术过程中承受的最大疼痛值作为结局指标。根据疼痛值将患者分为疼痛组25例及无痛组37例，疼痛组分为1-3分为轻度疼痛16例，4-6分为中度疼痛7例，7-10分为重度疼痛2例。采用Spearman相关分析及Logistic回归分析确定术中疼痛的危险因素。

结果：二元Logistic回归分析显示，术前睡眠时长及术眼手术次数是影响白内障患者术中感知疼痛的因素(均P<0.05)。Spearman相关分析显示，睡眠时长与白内障术中感知疼痛呈负相关(r_s=-0.386，P=0.002)，术眼手术次数与疼痛呈正相关(r_s=0.421，P<0.001)。有序Logistic回归分析结果显示，睡眠时长每增加1 h，白内障术中感知疼痛增加1个等级的概率减少37.60%(OR=0.376，P=0.014)，而术眼手术次数对术中疼痛程度无影响(P=0.083)。ROC曲线显示，睡眠时长与术眼手术次数联合预测白内障术中疼痛的曲线下面积为0.809，灵敏度为84%，特异度为73%。

结论：超声乳化术中疼痛与术前睡眠时长呈负相关，与术眼手术次数呈正相关。

METHODS: Retrospective case-control study. A total of 62 patients(62 eyes)diagnosed as cataract in the First Affiliated Hospital of Zhengzhou University from December 2023 to January 2024 were included. The numeric rating scale was used to assess the pain level within 5 min postoperatively. The highest pain value was used as the primary outcome during the procedure. Based on pain values, patients were divided into pain group(n=25)and pain-free group(n=37). Subsequently, patients in the pain group were further divided into mild(n=16), moderate(n=7), and severe groups(n=2). Spearman correlation and Logistic regression analysis were conducted to determine risk factors for pain during the phacoemulsification.

RESULTS: Binary Logistic regression showed preoperative sleep durations and times of operations were important risk factors for intraoperative pain(all P<0.05). Spearman analysis showed that intraoperative pain was negatively correlated with sleep duration(r_s=-0.386, P=0.002), and positively correlated with times of operations(r_s=0.421, P<0.001). The results of the ordinal Logistic regression analysis showed that for every additional hour of sleep, the likelihood of experiencing one higher level of intraoperative pain decreased by 37.60%(OR=0.376, P=0.014). In contrast, the times of operations did not show a statistically significant difference(P=0.083). Receiver operating characteristic curve showed a joint prediction model of sleep duration and operative times with an area under the curve of 0.809, 84% sensitivity, and 73% specificity.

CONCLUSION: The intraoperative pain during phacoemulsification is negatively correlated with sleep duration and positively correlated with times of operations.