Angelica Hanna, James Jacob Armstrong, Efstathia Tsioros, Guillermo Rocha, Cindy M L Hutnik, Iqbal Ike K Ahmed
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引用次数: 0
Abstract
Topic: This review assesses the effectiveness of intravenous sedation compared to non-intravenous sedation for routine cataract surgery.
Clinical relevance: Cataract surgery is a safe and routinely performed surgery. Sedation practices vary, with centers providing either intravenous (IV), oral or no sedation for surgery. Improving sedation practices may have significant implications for patient safety, patient experience and health system efficiency.
Methods: Medline, Embase, Cochrane Library, BIOSIS, Web of Science, and CINAHL were searched from inception to July 2024 for relevant articles containing original data. Randomized controlled trials that compared IV to oral or no sedation and 1) used a validated pain scale to report on pain or 2) reported on perioperative complications were included. A random effects meta-analysis was conducted. Odds ratios, standard mean differences, 95% confidence intervals (CIs), and I2 statistics were reported. The review was registered in PROSPERO (CRD42024582495) and PRISMA guidelines were followed.
Results: 12 randomized controlled trials including 1130 patients were included in the meta-analysis. IV sedation was associated with significantly decreased pain compared to no sedation (SMD = -0.98, 95% CI -1.68 to -0.29). Comparing IV and oral sedation, however, there was no difference in patient reported pain (SMD = -0.54, 95% CI -1.60 to 0.52). Analysis of intraoperative complications showed that there was no significant difference in complications between patients receiving IV and oral sedation (OR = 0.68, 95% CI 0.27 to 1.73).
Conclusion: For routine cataract surgery, IV sedation was associated with less pain than no sedation, but oral and IV sedation provided comparable pain control. Perioperative complications occur at similar rates regardless of sedation modality. These findings may help to inform sedation practices for cataract surgery.
期刊介绍:
The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS).
JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.