Patient Comfort During Cataract Surgery: A Comparison of Troche and Intravenous Sedation

Advancements in ophthalmologic procedures warrant exploration of alternative approaches to standard intravenous (IV) anesthesia sedation. One new approach, a sublingual troche containing midazolam, ketamine, and ondansetron, allows for IV catheter-free administration of sedation. This project compared the effectiveness and equivalency of sublingual troche during monitored anesthesia sedation with traditional IV sedation for maintaining comfort in patients undergoing cataract surgery. The study was conducted at a surgery center using an after-only nonequivalent control group design. Patients (N=107) were 55 to 85 years of age; 54 patients received IV sedation, and 53 received troche sedation. Four patients receiving IV sedation reported nausea during and after the procedure (n=1, 1.9%) or pain during the procedure (n=3, 5.6%), whereas 3 patients receiving troche sedation reported dizziness after the procedure (n=1, 1.9%), and pain during the procedure (n=2, 3.8%). Although the troche group (mean=6.25, SD=3.94) spent less time in recovery than the IV group (mean=6.48, SD=2.61), the difference was not significant (t[df=105]=0.677, P>.05). In conclusion, the results showed comparable experiences for both groups with equivalency and effectiveness in providing patient comfort during cataract surgery.