VOLUME

COMPARISON OF EFFECTIVENESS OF PUPIL DILATATION METHODS IN PATIENTS OF EYE EAR NOSE THROAT DEPARTMENT AT BNH HOSPITAL

SEPTEMBER 2014 - VOL.8 | ORIGINAL ARTICLE

OBJECTIVE:

This descriptive study aims to compare the effectiveness between two methods of pupil dilatation in patients of the Eye Ear Nose Throat (ENT) Department at the BNH Hospital.

MATERIALS AND METHODS:

The specifically selected subjects are 222 ENT out-patients who received mydriatic agents for an eye examination from January 1, 2014 to February 28, 2014. The mydriatic drugs were administered to these patients using two different methods:1) a mixture of tropicamide 0.75% and phenylephrine 2.5% given every 5 minutes for 4 times and 2) a mixture of tropicamide 0.75% and phenylephrine 2.5% given every 5 minutes for 2 times. A data collection sheet was designed to record personal information, pupil dilatation method and pupil size at 20, 30 and 45 minutes after drug instillation. The pupil size was measured using a Glasgow Coma Scale instrument. The measurement was done by trained nurses who knew the purpose of this study. The descriptive statistics, which included the number, percentage, mean and standard deviation, were used to present personal information and pupil size at 20, 30 and 45 minutes after drop instillation. The pupil sizes from the two methods were compared by using the non-parametric statistics: Friedman Test and Wilcoxon Signed Rank Test.

RESULTS:

From the comparison at 20, 30 and 45 minutes after the first drop instillation, both methods showed that the difference of pupil size between the time points was statistically significant (p > 0.001). The comparison between the first and the second method illustrates that the difference of pupil size at each time point was not statistically significant (p = 0.032,0.800 and 0.102,respectively) at the 99.9% confidence interval level. Thus, the second method should be used because it requires only two times of instillation (2 times less than the first method) and the pupil measurement at 20 minutes after the first drop instillation reduces waiting times for patients.

CONCLUSION:

The study supports pupil dilatation by using a mixture of 0.75% Tropicamide plus 2.5% phenylephrine and improves the process by reducing the waiting times of patients. Patients receive a lower amount of the drug, decreasing from 4 times to 2 times, so the risk of side effects is reduced.

Keywords:

pupil dilatation, mydriatic drugs

DOI

10.31524/bkkmedj.2014.09.005

MEDIA

Method 1 Method 2

Table 1:

The number and percentage of out-patients in the ENT department at the BNH Hospital from 1 January 2014 to 28 February 2014.

Table 2:

The pupil size of patients receiving mydriatic agents with the 1st and the 2nd method at 20, 30 and 45 minutes.

Table 3:

Comparison of pupil size between the 1st and the 2nd method at 20, 30 and 45 minutes using the Friedman Test.

Table 4:

Comparison of pupil dilatation between the 1st and the 2nd method at 20, 30 and 45 minutes using the Wilcoxon Signed Rank Test.

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