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J Fr Ophtalmol ; 41(5): 441-446, 2018 May.
Artículo en Francés | MEDLINE | ID: mdl-29776768

RESUMEN

INTRODUCTION: This work aims to evaluate selection criteria used during the cataract surgery scheduling visit, to choose whether or not there will be an anesthesiologist available during the surgery, depending upon the patient's comorbidities. MATERIALS AND METHODS: Retrospective study performed in 2016 in Angers university medical center. Two groups were established on the cataract surgery scheduling visit, based on patients' comorbidities and vital signs (blood pressure, heart rate). One group of patients were operated with topical anesthesia, with the anesthesia team, the other one only with blood pressure and heart rate monitoring, with, if needed, a written protocol of sedation or blood pressure control, which could be administrated by a circulating nurse. Those two groups were compared in terms of postoperative complications, intraoperative pain and postoperative visual acuity. RESULTS: 248 surgeries were performed on 185 individual patients, with 108 under stand-alone topical anesthesia, and 135 under anesthetist-monitored topical anesthesia. No significant difference was demonstrated between the two groups, in terms of complications, intraoperative pain or visual acuity outcomes. DISCUSSION: This study allows us to assess selection criteria used in our hospital to determine which patients can undergo cataract surgery under topical anesthesia without the anesthesia team. This procedure lowers organizational constraints while still insuring patient safety. Some patients still probably need an anesthesiologist present, such as those with an unstable disease or risk of agitation, in order to optimize the medications administered during surgery.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios/métodos , Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Extracción de Catarata/métodos , Selección de Paciente , Administración Tópica , Anciano , Anciano de 80 o más Años , Procedimientos Quirúrgicos Ambulatorios/efectos adversos , Anestesia Local/efectos adversos , Anestesiólogos , Anestésicos Locales/efectos adversos , Catarata/diagnóstico , Catarata/epidemiología , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Intraoperatorio/métodos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Derivación y Consulta , Estudios Retrospectivos
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