A prospective randomised study of local versus general anaesthesia for cataract surgery

Area of Science:

• Anesthesiology
• Ophthalmology
• Geriatric Medicine

Background:

• Cataract surgery is a common procedure in elderly patients.
• The choice of anesthesia (local vs. general) may impact patient safety and outcomes.

Purpose of the Study:

• To compare the safety and efficacy of local versus general anesthesia for cataract surgery.
• To assess the impact of anesthesia type on perioperative physiological parameters and postoperative cognitive function.

Main Methods:

• A randomized controlled trial involving 169 patients (aged 65-98 years).
• Patients received either local or general anesthesia for cataract surgery.
• Cognitive function was evaluated using psychometric tests pre-operatively and at 24 hours, 2 weeks, and 3 months postoperatively.
• Physiological parameters (oxygen saturation, blood pressure, heart rate) were monitored throughout the procedure.

Main Results:

• None of the patients receiving local anesthesia experienced oxygen desaturation, compared to 19% in the general anesthesia group.
• The local anesthesia group maintained stable pulse rate and blood pressure, unlike the general anesthesia group which showed significant fluctuations.
• 61% of patients under general anesthesia experienced a >30% drop in systolic blood pressure.
• No significant difference in long-term postoperative cognitive function was observed between the two groups.

Conclusions:

• Local anesthesia is associated with better perioperative physiological stability during cataract surgery.
• Neither anesthesia type demonstrated a negative impact on long-term cognitive function in this patient cohort.
• Local anesthesia appears to be a safer option for cataract surgery regarding immediate physiological responses.