RESUMO
OBJECTIVE: To assess the rate of early complications of outpatient external dacryocystorhinostomy (DCR) and patient satisfaction with the anesthetic technique. MATERIAL AND METHODS: This prospective study enrolled 58 patients undergoing external DCR. We analyzed demographic variables, ASA physical status, level of sedation achieved, postoperative pain, systemic complications, intraoperative bleeding, duration of surgery, time until discharge home, and patient and surgeon satisfaction with the anesthetic technique. RESULTS: The mean (SD) level of satisfaction was 4.85 (0.80) points on the Iowa Satisfaction With Anesthesia Scale (ISAS). A positive association was found between postoperative pain and a lower ISAS score. There was also a positive association between use of rescue analgesia in the early postoperative period and a lower ISAS score. Mean blood loss per procedure was 178.9 (108.2) mL. The rate of minor systemic complications was 15.5%. The surgeon's rating of conditions in the surgical field was excellent or good in 89.6% of the cases. CONCLUSIONS: External DCR can be performed on an outpatient basis within a reasonable safety margin and with a low early postoperative complication rate. Patient satisfaction with anesthesia was high. Provision of preoperative information about the meaning of sedation, postoperative analgesia, and surgical bleeding are aspects to improve in this practice setting.
Assuntos
Procedimentos Cirúrgicos Ambulatórios/estatística & dados numéricos , Dacriocistorinostomia/estatística & dados numéricos , Hipnóticos e Sedativos/uso terapêutico , Bloqueio Nervoso/métodos , Propofol/uso terapêutico , Idoso , Procedimentos Cirúrgicos Ambulatórios/psicologia , Analgesia/métodos , Analgesia/estatística & dados numéricos , Perda Sanguínea Cirúrgica , Bupivacaína/administração & dosagem , Dacriocistorinostomia/métodos , Dacriocistorinostomia/psicologia , Epistaxe/epidemiologia , Epistaxe/etiologia , Feminino , Humanos , Injeções , Instilação de Medicamentos , Masculino , Mepivacaína/administração & dosagem , Pessoa de Meia-Idade , Oftalmologia , Dor Pós-Operatória/epidemiologia , Dor Pós-Operatória/terapia , Satisfação do Paciente , Médicos/psicologia , Complicações Pós-Operatórias/epidemiologia , Procaína/administração & dosagem , Procaína/análogos & derivados , Síncope Vasovagal/epidemiologia , Síncope Vasovagal/etiologiaRESUMO
OBJETIVOS: Determinar la frecuencia de complicaciones inmediatas asociadas a la dacriocistorrinostomía externa (DCRE) en régimen de consultorio y la satisfacción del paciente con la técnica anestésica. MATERIALES Y MÉTODOS: Se estudiaron de forma prospectiva 58 pacientes intervenidos de DCRE. Se analizaron las variables demográficas, el estado físico (ASA), el nivel de sedación conseguido, el dolor postoperatorio, las complicaciones sistémicas, el sangrado intraoperatorio, el tiempo de cirugía, el tiempo transcurrido hasta el alta domiciliaria, la satisfacción del paciente y del cirujano con la técnica anestésica. RESULTADOS: El nivel medio de satisfacción fue de 4,85 ± 0,80 puntos, según la escala de Iowa de satisfacción con la anestesia (EISA). Se encontró una asociación positiva entre el dolor postoperatorio y una menor puntuación en la EISA. También se halló una asociación positiva entre el consumo de analgésicos en el postoperatorio inmediato y la menor puntuación en la EISA. La cuantía media del sangrado fue de 178,9 ± 108,2 ml por procedimiento. La frecuencia de complicaciones sistémicas menores fue del 15,5%. El cirujano calificó las condiciones del campo quirúrgico de excelentes a muy buenas en el 89,6% de los casos. CONCLUSIONES: La DCRE puede realizarse en un consultorio con márgenes adecuados de seguridad, y con baja tasa de complicaciones en el postoperatorio inmediato. La satisfacción del paciente con la anestesia fue alta. La información preoperatoria del significado de sedación, la analgesia postoperatoria y el sangrado quirúrgico son aspectos mejorables en la asistencia prestada
OBJECTIVE: To assess the rate of early complications of outpatient external dacryocystorhinostomy (DCR) and patient satisfaction with the anesthetic technique. MATERIAL AND METHODS: This prospective study enrolled 58 patients undergoing external DCR. We analyzed demographic variables, ASA physical status, level of sedation achieved, postoperative pain, systemic complications, intraoperative bleeding, duration of surgery, time until discharge home, and patient and surgeon satisfaction with the anesthetic technique. RESULTS: The mean (SD) level of satisfaction was 4.85 (0.80) points on the Iowa Satisfaction With Anesthesia Scale (ISAS). A positive association was found between postoperative pain and a lower ISAS score. There was also a positive association between use of rescue analgesia in the early postoperative period and a lower ISAS score. Mean blood loss per procedure was 178.9 (108.2) mL. The rate of minor systemic complications was 15.5%. The surgeon's rating of conditions in the surgical field was excellent or good in 89.6% of the cases. CONCLUSIONS: External DCR can be performed on an outpatient basis within a reasonable safety margin and with a low early postoperative complication rate. Patient satisfaction with anesthesia was high. Provision of preoperative information about the meaning of sedation, postoperative analgesia, and surgical bleeding are aspects to improve in this practice setting
