Impact Of Anxiety Levels And Sleep Patterns On Perceived Pain During Intravitreal Bevacizumab Injections

BACKGROUND AND OBJECTIVE: To evaluate the impact of anxiety and sleep patterns on intravitreal injection pain.PATIENTS AND METHODS: This prospective, non-interventional study surveyed patients scheduled for intravitreal injection by two retinal surgeons. A standard intravitreal injection technique was used. Patients filled out pre-procedure General Anxiety Disorder-7 (GAD-7) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Post-procedural pain was assessed with a visual analogue scale. Quality and hours of sleep and anxiety levels were correlated with perceived intravitreal injection pain.RESULTS: A total of 140 patients met inclusion criteria. Mean +/- standard deviation scores were 4.9 +/- 5.6 for the GAD-7, 6.3 +/- 4.1 for the PSQI, and 3.69 +/- 2.64 for intravitreal injection pain. Anxiety correlated with intravitreal injection pain (rho = 0.25; P = .003). Previous night's sleep (rho = -0.16; P = .057) and poor sleep quality (rho = 0.14; P = .11) were weakly correlated. Regression analysis revealed anxiety was the only significant predictor of intravitreal injection pain. A 1-point increase in anxiety predicted a 0.10-point increase in intravitreal injection pain (B = 0.10, P = .032).CONCLUSIONS: Anxiety level was the best predictor of perceived pain. This has implications for preprocedural anxiety screening.