Is deep sedation better than general anesthesia for some ophthalmology procedures?
When sedation is used in an appropriate hospital setting for minimally to moderately invasive ophthalmology procedures in pediatric patients it is an alternative to general anesthesia, according to a poster presented at the 2021 Virtual AAPOS Meeting.
In this retrospective review, 125 patients who received deep sedation for nasolacrimal duct stenting, chalazion, skin tag, electroretinogram, or eye examination were medicated with a combination of Propofol, Fentanyl, or Ketamine. A control group consisted of 1037 patients who received sedation for lumbar punctures with intrathecal chemotherapy administration, bone marrow aspiration and biopsies, and Botox injections.
Of the patients undergoing ophthalmology procedures, 15.2% (19 out of 125) experienced respiratory complications, including 12 requiring bag-mask ventilation, 3 requiring additional oxygen, 2 requiring Oral/Nasal airway, 1 experiencing a benign arrhythmia, and 1 having an allergic reaction. Cardiopulmonary resuscitation or unplanned hospital admission was not required for any patients.
Patients who experienced complications received a statistically significant larger dose of medication (P = 0.009) than those who did not experience complications.
All procedures were completed successfully.
In the control group, only 3.8% of patients suffered complications, and 96% of procedures were completed successfully.
Reference
Grigorian AP, et al. Deep sedation for ophthalmology procedures outside of the operating room. Poster presented at: 2021 Virtual AAPOS Meeting.