Role of deep sedation phacoemulsification with scleral tunnel

Journal français d'ophtalmologie
M KassirW Mahmoud

Abstract

To describe a method of deep sedation without adjunctive periocular injection in phacoemulsification with a scleral tunnel technique. All patients undergoing phacoemulsification with a scleral tunnel and foldable intraocular lens for cataract between May 2011 and November 2014 received deep sedation including a bolus of midazolam and fentanyl followed by a continuous perfusion of dexmedetomidine throughout the surgical procedure. The patients and medical team evaluated pain, sedation, clinical status of the patient, and surgeon comfort. One thousand and five hundred patients were included, representing 1763 eyes. Ramsay's sedation score was 2 in 7.13% of cases and 3 in 86.3%, which allowed surgery to be performed under very satisfactory conditions. On a scale of 1 to 10, intraoperative pain was less than or equal to 1 in 81.2% of cases. The bradycardic and hypotensive effects of dexmedetomidine were appreciable, while respiratory depression was not observed. Only 1 case of severe agitation during surgery directly resulted in a vitreous issue. Some simple precautions allow optimization of the advantages of this method of anesthesia. The deep sedation method including bolus injections of midazolam and fentanyl and continuous perf...Continue Reading

References

Oct 1, 1992·The British Journal of Ophthalmology·J F SalmonA D Murray
Nov 30, 2002·Journal of Cataract and Refractive Surgery·Osman Nuri AydinFeray Gürsoy
Apr 6, 2006·British Journal of Anaesthesia·J A Alhashemi
Aug 19, 2007·British Journal of Anaesthesia·H AyogluS H Ugurbas
Aug 29, 2009·Anesthesia and Analgesia·Keith A CandiottiUNKNOWN MAC Study Group

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