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Anesthesia providers' interventions during cataract extraction under monitored anesthesia care
1University of Iowa Hospitals and Clinics, Department of Anesthesia, Iowa City, USA.
AANA Journal
|August 1, 1997
Summary
Anesthesia providers performed interventions in 33% of cataract surgeries after retrobulbar block placement. Insufficient evidence supports replacing anesthesia providers with nurses for monitored anesthesia care during these procedures.
Area of Science:
- Anesthesiology
- Ophthalmology
Background:
- Medicare payments for anesthesia in cataract surgery were historically high.
- Monitored anesthesia care (MAC) is common for cataract surgery.
- Potential for reduced anesthesia payments necessitates evaluating alternative monitoring.
Purpose of the Study:
- To describe interventions by anesthesia providers during cataract extraction after retrobulbar block placement.
- To assess the necessity of anesthesia provider involvement in MAC for cataract surgery.
Main Methods:
- Retrospective review of 560 anesthetic records for cataract extraction cases.
- Analysis of interventions performed by anesthesia providers post-retrobulbar block.
Main Results:
- Anesthesia providers intervened in 33% of cases after retrobulbar block placement (95% CI < 36%).
- This indicates a significant need for anesthesia provider involvement.
Conclusions:
- Current evidence is insufficient to support replacing anesthesia providers with registered nurses for MAC during cataract surgery.
- Further prospective randomized studies are needed before decreasing anesthesia provider involvement or payments.