PATIENT SATISFACTION FOLLOWING CATARACT SURGERY UNDER LOCO- REGIONAL ANAESTHESIA; A COMPARISON OF CONSCIOUS SEDATION USING PROPOFOL INFUSION VERSUS LOCO-REGIONAL ANAESTHESIA ALONE

Abstract

Objective: To compare loco-regional anaesthesia alone and its combination with conscious sedation using intravenous propofol infusion, in terms of patient satisfaction following cataract surgery.
Design: Randomized controlled trial
Setting: Conducted in operation theatre complex of Combined Military Hospital Multan during April 2006 to April 2007.
Patients and Methods: One hundred outpatients (n=100), who met inclusion criteria and were scheduled for cataract surgery under loco-regional anaesthesia [Retrobulbar block along with topical anaesthesia], were randomly allocated to group “A” and “B” of 50 patients each. In group A (n=50), patients were also provided conscious sedation using intravenous propofol infusion titrated to the desired effect. While group B (n=50) patients were not provided any sedation in addition to loco-regional anaesthesia. Patient satisfaction of both the groups was assessed by filling a questionnaire, using scoring system modified from Iowa Satisfaction with Anaesthesia Scale (ISAS) at the time of discharge from the hospital.
Results: Mean ISAS score of patients in Group A (n=50) was found significantly higher (23.26  9.52) than mean ISAS score of patients of group B (18.56  11.20). Comparison depicted statistically significant difference as the p value was 0.026 (< 0.05).
Conclusion: Conscious sedation with Propofol infusion provided higher patient satisfaction after cataract surgery under loco-regional anaesthesia when compared to surgery under loco-regional anaesthesia alone, as measured by ISAS score. Propofol infusion is recommended to be a novel technique for conscious sedation in outpatient cataract surgery because of propofol‟s excellent pharmacokinetic profile.