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Simplified topical anaesthetic protocol for ambulatory cataract surgery: safety and satisfaction
Author(s) -
FERTE A,
BATTA B,
TRECHOT F,
FUCHSBUDER T,
ANGIOI K
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.s090.x
Subject(s) - medicine , ambulatory , perioperative , anesthesia , patient satisfaction , anxiety , general anaesthesia , adverse effect , visual analogue scale , surgery , psychiatry
Purpose Background and goal of study: The aim of our study was to assess safety and efficiency of cataract surgery (CS) under topical anaesthesia alone, i.e. without pre‐anaesthetic evaluation and without direct presence of an anaesthesiologist. To this end we assessed incidence of preoperative patients’ anxiety, perioperative adverse events and patients’ and surgeons’ satisfaction. Methods Materials and methods: Patients undergoing CS under topical anaesthesia were included during one month. Anaesthesiologist and anaesthesia nurse were present in the area and could intervene in case of an adverse event. Patients’ anxiety was scored using Amsterdam Preoperative Anxiety & Information Scale (APAIS), their satisfaction with Iowa Satisfaction with Anaesthesia Scale (ISAS). Surgeons’ satisfaction was scored with a VAS from 0 to 10 (0: surgery not possible & 10: excellent surgical conditions). Results Results and discussion: 124 consecutive patients were included; mean age was 71 (±9.4). Mean APAIS I was 6.4/20 (±3.7). Mean APAIS II was 3.1 (±1.8). Mean ISAS score was 5.5/6 (±0.6), indicating a high patients’ satisfaction. Surgeons’ satisfaction score was 8.9/10 (±1.7). 23 adverse events occurred, 16 of them of required intervention: 5 supplemental regional anaesthesia, 6 iv‐analgesia, 5 management of hypertension. Conclusion Conclusion: These preliminary data suggest that simplified topical anaesthesia protocol for ambulatory CS seems to be feasible and safe, as long as an anaesthesia team is present in the area to intervene if needed.