Smith Jason C, Hamilton Bernita K, VanDyke Stacey A
is a faculty member, Nurse Anesthesia Program, College of Applied Studies, Florida State University, Panama City, Florida, and a practicing CRNA, Jackson Anesthesia Associates, Marianna, Florida.
is a professor, School of Nursing, Troy University, Troy, Alabama.
AANA J. 2020 Dec;88(6):429-435.
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.
眼科手术的进展促使人们探索替代标准静脉（IV）麻醉镇静的方法。一种新方法是使用含咪达唑仑、氯胺酮和昂丹司琼的舌下含片，可实现无需静脉导管的镇静给药。本项目比较了在监测麻醉镇静期间舌下含片与传统静脉镇静在白内障手术患者维持舒适度方面的有效性和等效性。该研究在一个手术中心采用仅事后非等效对照组设计进行。患者（N = 107）年龄在55至85岁之间；54例患者接受静脉镇静，53例接受含片镇静。4例接受静脉镇静的患者在手术期间及术后报告恶心（n = 1，1.9%）或手术期间疼痛（n = 3，5.6%），而3例接受含片镇静的患者在术后报告头晕（n = 1，1.9%）和手术期间疼痛（n = 2，3.8%）。尽管含片组（均值 = 6.25，标准差 = 3.94）在恢复室停留的时间比静脉组（均值 = 6.48，标准差 = 2.61）短，但差异不显著（t[自由度 = 105] = 0.677，P >.05）。总之，结果表明两组体验相当，在白内障手术期间为患者提供舒适度方面具有等效性和有效性。
