Comparison of two standard techniques of general anaesthesia for day-case cataract surgery

We have assessed general anaesthesia for day-case cataract surgery in 40 patients more than 60 yr of age. The patients were allocated randomly to receive either an infusion of propofol or etomidate-vecuronium-isoflurane anaesthesia. Patients in the propofol group experienced significant reductions in mean arterial pressure (42%) during anaesthesia. In the etomidate-vecuronium-isoflurane group there was a significant increase in both mean arterial pressure (19%) and heart rate (21%) with intubation. During maintenance of anaesthesia in this group, mean arterial pressure and heart rate decreased to 88% and 80% of awake values. Both techniques produced similar reductions in intraocular pressure. Recovery times from cessation of anaesthesia to spontaneous eye opening and ability to give correct date of birth were significantly shorter in the etomidate-isoflurane group. Two hours after surgery there were no significant differences between the groups and cognitive mental function tests were similar to preoperative values. All patients were deemed fit for discharge home 2 h after surgery. We conclude that it is feasible to provide general anaesthesia for day-case cataract surgery. Etomidate-vecuronium-isoflurane anaesthesia appeared to be superior to propofol in this age group as it was associated with less hypotension and a more rapid recovery.