Systemic adverse events during 2005 phacoemulsifications under monitored anesthesia care: a prospective evaluation

Area of Science:

• Anesthesiology
• Ophthalmology
• Surgical Care

Background:

• Phacoemulsification cataract surgery under topical anesthesia with monitored anesthesia care is common.
• Evaluating systemic adverse events requiring anesthesiologist intervention is crucial for patient safety.

Purpose of the Study:

• To assess the incidence and predictors of anesthesiologist intervention during phacoemulsification under topical anesthesia.
• Identify factors associated with adverse events like agitation and hypertension.

Main Methods:

• Retrospective analysis of adverse events requiring anesthesiologist calls.
• Statistical analysis of patient demographics, comorbidities, and surgical factors as predictors.
• Calculation of Odds Ratios (OR) with 95% Confidence Intervals (CI).

Main Results:

• Anesthesiologist intervention occurred in 21.6% of cases.
• Predictive factors for intervention included age, ASA status 3-4, neurological/psychiatric history, and surgery length.
• Arterial hypertension and agitation were the most frequent adverse events.

Conclusions:

• Monitored anesthesia care for same-day cataract surgery necessitates anesthesiologist intervention in a significant percentage of cases.
• Agitation is more prevalent in younger patients with neurological/psychiatric history, while hypertension is more common in older patients with higher ASA status.
• No surgeries required interruption, indicating the safety of this anesthetic regimen with appropriate monitoring.