Anesthesiologist intervention during cataract surgery under topical or peribulbar anesthesia: A propensity model comparison

Marco Gemma, Luigi Gioia, Elisa Dedola, Benedetta Basta, Ingrid Bianchi, Francesco Fasce, Luigi Beretta

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

PURPOSE. To compare the incidence and type of anesthesiologist intervention during cataract surgery under peribulbar (PA) or topical (TA) anesthesia in a day-surgery monitored anesthesia care setting (monitoring provided by nurses with the anesthesiologist available on an on-call basis). METHODS. From a prospective database of all phacoemulsifications performed in our hospital (January 2008-January 2009), 97 patients submitted to cataract surgery under PA were matched with 97 patients submitted to the same surgery under TA by a propensity model. The resulting groups were homogeneous as to history of antihypertensive therapy administered on the day of surgery and not administered on the day of surgery, cardiologic history, neurologic history, psychiatric history, anxiolytic assumption, and history of diabetes mellitus. We compared the incidence of intervention of the anesthesiologist between groups and the type of adverse event triggering such interventions. RESULTS. The anesthesiologist was called in 37 (38.14%) cases in the PA group and in 27 (27.84%) cases in the TA group (37 [38.14%]) (p=0.123). Only the occurrence of agitation differed significantly between groups (9 [9.28%] patients in the TA group vs 24 [24.74%] patients in the PA group; p=0.004). CONCLUSIONS. Monitored anesthesia care is feasible for cataract surgery both under PA or TA. PA still remains an appealing alternative to TA during cataract surgery for patients incapable of keeping the operating eye in the primary position or with incoercible blinking, photophobia, or phacodonesis. A greater incidence of agitation is to be expected and adequate premedication with anxiolytics should be considered if PA is chosen.

Original languageEnglish
Pages (from-to)687-693
Number of pages7
JournalEuropean Journal of Ophthalmology
Volume20
Issue number4
Publication statusPublished - Jul 2010

Fingerprint

Cataract
Anesthesia
Ambulatory Surgical Procedures
Anti-Anxiety Agents
Incidence
History
Blinking
Photophobia
Phacoemulsification
Premedication
Antihypertensive Agents
Nervous System
Psychiatry
Diabetes Mellitus
Nurses
Anesthesiologists
Databases
Therapeutics

Keywords

  • Cataract
  • Monitored anesthesia care
  • Peribulbar anesthesia
  • Phacoemulsification
  • Propensity score
  • Topical anesthesia

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Anesthesiologist intervention during cataract surgery under topical or peribulbar anesthesia : A propensity model comparison. / Gemma, Marco; Gioia, Luigi; Dedola, Elisa; Basta, Benedetta; Bianchi, Ingrid; Fasce, Francesco; Beretta, Luigi.

In: European Journal of Ophthalmology, Vol. 20, No. 4, 07.2010, p. 687-693.

Research output: Contribution to journalArticle

Gemma, Marco ; Gioia, Luigi ; Dedola, Elisa ; Basta, Benedetta ; Bianchi, Ingrid ; Fasce, Francesco ; Beretta, Luigi. / Anesthesiologist intervention during cataract surgery under topical or peribulbar anesthesia : A propensity model comparison. In: European Journal of Ophthalmology. 2010 ; Vol. 20, No. 4. pp. 687-693.
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abstract = "PURPOSE. To compare the incidence and type of anesthesiologist intervention during cataract surgery under peribulbar (PA) or topical (TA) anesthesia in a day-surgery monitored anesthesia care setting (monitoring provided by nurses with the anesthesiologist available on an on-call basis). METHODS. From a prospective database of all phacoemulsifications performed in our hospital (January 2008-January 2009), 97 patients submitted to cataract surgery under PA were matched with 97 patients submitted to the same surgery under TA by a propensity model. The resulting groups were homogeneous as to history of antihypertensive therapy administered on the day of surgery and not administered on the day of surgery, cardiologic history, neurologic history, psychiatric history, anxiolytic assumption, and history of diabetes mellitus. We compared the incidence of intervention of the anesthesiologist between groups and the type of adverse event triggering such interventions. RESULTS. The anesthesiologist was called in 37 (38.14{\%}) cases in the PA group and in 27 (27.84{\%}) cases in the TA group (37 [38.14{\%}]) (p=0.123). Only the occurrence of agitation differed significantly between groups (9 [9.28{\%}] patients in the TA group vs 24 [24.74{\%}] patients in the PA group; p=0.004). CONCLUSIONS. Monitored anesthesia care is feasible for cataract surgery both under PA or TA. PA still remains an appealing alternative to TA during cataract surgery for patients incapable of keeping the operating eye in the primary position or with incoercible blinking, photophobia, or phacodonesis. A greater incidence of agitation is to be expected and adequate premedication with anxiolytics should be considered if PA is chosen.",
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AU - Gemma, Marco

AU - Gioia, Luigi

AU - Dedola, Elisa

AU - Basta, Benedetta

AU - Bianchi, Ingrid

AU - Fasce, Francesco

AU - Beretta, Luigi

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N2 - PURPOSE. To compare the incidence and type of anesthesiologist intervention during cataract surgery under peribulbar (PA) or topical (TA) anesthesia in a day-surgery monitored anesthesia care setting (monitoring provided by nurses with the anesthesiologist available on an on-call basis). METHODS. From a prospective database of all phacoemulsifications performed in our hospital (January 2008-January 2009), 97 patients submitted to cataract surgery under PA were matched with 97 patients submitted to the same surgery under TA by a propensity model. The resulting groups were homogeneous as to history of antihypertensive therapy administered on the day of surgery and not administered on the day of surgery, cardiologic history, neurologic history, psychiatric history, anxiolytic assumption, and history of diabetes mellitus. We compared the incidence of intervention of the anesthesiologist between groups and the type of adverse event triggering such interventions. RESULTS. The anesthesiologist was called in 37 (38.14%) cases in the PA group and in 27 (27.84%) cases in the TA group (37 [38.14%]) (p=0.123). Only the occurrence of agitation differed significantly between groups (9 [9.28%] patients in the TA group vs 24 [24.74%] patients in the PA group; p=0.004). CONCLUSIONS. Monitored anesthesia care is feasible for cataract surgery both under PA or TA. PA still remains an appealing alternative to TA during cataract surgery for patients incapable of keeping the operating eye in the primary position or with incoercible blinking, photophobia, or phacodonesis. A greater incidence of agitation is to be expected and adequate premedication with anxiolytics should be considered if PA is chosen.

AB - PURPOSE. To compare the incidence and type of anesthesiologist intervention during cataract surgery under peribulbar (PA) or topical (TA) anesthesia in a day-surgery monitored anesthesia care setting (monitoring provided by nurses with the anesthesiologist available on an on-call basis). METHODS. From a prospective database of all phacoemulsifications performed in our hospital (January 2008-January 2009), 97 patients submitted to cataract surgery under PA were matched with 97 patients submitted to the same surgery under TA by a propensity model. The resulting groups were homogeneous as to history of antihypertensive therapy administered on the day of surgery and not administered on the day of surgery, cardiologic history, neurologic history, psychiatric history, anxiolytic assumption, and history of diabetes mellitus. We compared the incidence of intervention of the anesthesiologist between groups and the type of adverse event triggering such interventions. RESULTS. The anesthesiologist was called in 37 (38.14%) cases in the PA group and in 27 (27.84%) cases in the TA group (37 [38.14%]) (p=0.123). Only the occurrence of agitation differed significantly between groups (9 [9.28%] patients in the TA group vs 24 [24.74%] patients in the PA group; p=0.004). CONCLUSIONS. Monitored anesthesia care is feasible for cataract surgery both under PA or TA. PA still remains an appealing alternative to TA during cataract surgery for patients incapable of keeping the operating eye in the primary position or with incoercible blinking, photophobia, or phacodonesis. A greater incidence of agitation is to be expected and adequate premedication with anxiolytics should be considered if PA is chosen.

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KW - Monitored anesthesia care

KW - Peribulbar anesthesia

KW - Phacoemulsification

KW - Propensity score

KW - Topical anesthesia

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