Factors associated with satisfaction with oral sedation during ophthalmic surgeries.

Abstract

Purpose: To investigate patient and surgical characteristics associated with higher patient, surgeon, or anesthesia provider satisfaction with oral sedation in ophthalmic procedures.

Design: This was a secondary analysis of a prospective, randomized, double-masked, non-inferiority clinical trial measuring patient satisfaction comparing oral versus intravenous (IV) sedation for ophthalmic surgeries.

Methods: Data was collected from a validated 6-point satisfaction survey from patients, surgeons, and anesthesia providers. We focused on the oral sedation arm and used multivariate regression analysis to investigate the relationship between satisfaction scores and patients' characteristics, surgery duration, and need for additional anesthesia during the ophthalmic procedure.

Results: In total, 142 patients receiving initial oral triazolam with IV placebo were included in this study. Non-White (p = 0.02) and non-English speaker patients (p = 0.003) had higher satisfaction scores with oral sedation. Shorter surgery duration was associated with higher satisfaction scores for both patients (p = 0.01) and surgeons (p = 0.03) but not for anesthesia providers (p = 0.21). The need for supplemental IV sedation intraoperatively was significantly associated with lower satisfaction scores among patients (p < 0.001), surgeons (p < 0.001), and anesthesia providers (p < 0.001).

Conclusions: Shorter length of surgery was positively associated with higher patient and surgeon satisfaction with oral sedation. Other factors including non-White race and non-English primary language were associated with higher patient satisfaction. Additional IV sedation needed during surgery was associated with worse patient, surgeon, and anesthesia provider satisfaction. Tailoring oral sedation to procedures that are shorter in duration may help maximize the success of oral sedation as an alternative to intravenous sedation.