Ahmed Mahmoud, Krishna Yamini, Popova Petya, Herbert Rose, Sidaras Gediminas, Choudhary Anshoo, Kaye Stephen B
St Paul's Eye Unit, Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool L7 8XP, UK.
J Clin Med. 2023 Apr 6;12(7):2742. doi: 10.3390/jcm12072742.
In this paper, we investigate the effect of sedation using low-dose propofol on patient reported outcome measures (PROMS) in patients undergoing cataract surgery. This is a randomised, single-blinded observational prospective study. Patients undergoing elective cataract surgery using peribulbar anaesthesia over consecutive cataract lists were selected for this trial. Patients were randomised to receive either no sedation or low-dose propofol (20 to 30 mg followed by 10 mg increments until the patient developed slurred speech alone) prior to the administration of local anaesthesia. Pain, satisfaction, anxiety, needle recall, pulse, and blood pressure (BP) were measured. A total of 97 patients were included, 50 of whom received propofol. There were 4 senior surgeons and anaesthetists. There were no ocular or systemic complications and all patients had uncomplicated surgery. Anxiety ( = 0.026), needle recall ( < 0.001), difference in systolic BP ( = 0.043), and pulse ( = 0.046) were dependent on patient age ( < 0.001) and the use of propofol ( = 0.007). Lower pain was associated with propofol ( = 0.008), as well as lower anxiety ( = 0.002), and increased patient age ( = 0.014). The administration of propofol was significantly associated with lower needle recall ( < 0.001), pre- to post-operative difference in systolic BP ( = 0.029), and mean BP ( = 0.044). Low-dose propofol given immediately prior to administration of local anaesthesia was associated with reduced pain and needle recall, as well as lower BP.
在本文中，我们研究了使用低剂量丙泊酚镇静对白内障手术患者报告结局指标（PROMS）的影响。这是一项随机、单盲观察性前瞻性研究。本试验选取了在连续的白内障手术名单中接受球周麻醉进行择期白内障手术的患者。患者被随机分为两组，一组在局部麻醉前不接受镇静，另一组接受低剂量丙泊酚（20至30毫克，随后以10毫克递增，直至患者仅出现言语含糊）。测量了疼痛、满意度、焦虑、对注射针的回忆、脉搏和血压（BP）。总共纳入了97例患者，其中50例接受了丙泊酚。有4位资深外科医生和麻醉师。未出现眼部或全身并发症，所有患者手术均顺利。焦虑（P = 0.026）、对注射针的回忆（P < 0.001）、收缩压差异（P = 0.043）和脉搏（P = 0.046）取决于患者年龄（P < 0.001）和丙泊酚的使用（P = 0.007）。较低的疼痛与丙泊酚有关（P = 0.008），较低的焦虑（P = 0.002）以及患者年龄增加（P = 0.014）也有关。丙泊酚的使用与较低的对注射针的回忆（P < 0.001）、术前至术后收缩压差异（P = 0.029）和平均血压（P = 0.044）显著相关。在局部麻醉给药前立即给予低剂量丙泊酚与疼痛减轻、对注射针的回忆减少以及血压降低有关。
