Conscious sedation during ophthalmic surgery under local anesthesia

Sedation during ophthalmic local anesthesia helps to ensure comfort and cooperation during eye surgery. Sedation requirements of ophthalmic patients have changed with the popularization of newer surgical and anesthetic techniques. Many sedative agents are available to anesthesiologists including benzodiazepines, intravenous anesthetic induction agents, narcotic analgesics and a-adrenoreceptor agonists. However, there is no single ideal sedative agent, regime or protocol that can completely cater to the wide spectrum of ophthalmic procedures performed in a heterogeneous patient population. Moreover, the clinical practice of sedation during ophthalmic surgery under local anesthesia is varied and not without risk of complications and adverse events. Hence, balanced sedative techniques should only be used after careful consideration of patient profile, the type of eye surgery, and patient and surgeon preferences. Good knowledge of the pharmacology of sedative agents is fundamental to their useful clinical application.