Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Administering intravenous sedation in conjunction with intraoperative monitoring to cataract surgery patients is a widely accepted technique. Numerous articles report local sedation techniques for cataract surgery that are, in essence, abbreviated general anesthetic techniques for insertion of the retrobulbar block (RBB). Because of variations in levels of consciousness, a number of complications have been encountered with this specific patient population, ie, movement upon insertion of the RBB, intraoperative patient movement, confusion, hypotension, respiratory depression, and respiratory arrest. In an attempt to meet the specific needs of this patient population, a study comparing propofol-fentanyl with midazolam-fentanyl was initiated. Seventy-five (ASA 1 to 3) patients were randomly assigned to two groups: propofol-fentanyl (P/F) or midazolam-fentanyl (M/F). The mean age of patients in the P/F group was 71.1 +/- 13 SD, and the mean age in the M/F group was 74.4 +/- 8.8 SD. All patients entered the operating room unpremedicated. Before the RBB, patients in both groups were given a single intravenous dose of 50 micrograms fentanyl. Propofol (mean dose, 24.7 mg) or midazolam (mean dose, 1.58 mg) was then titrated to slurred speech or nystagmus. Patients' responses to the RBB were evaluated and recorded by an objective observer. The amnestic properties of both agents were evaluated by patient questioning at 10 minutes and 24 hours. Levels of discomfort were evaluated on a scale of 1 to 5, with 1 being extremely uncomfortable and 5 being noticeable without pain. Respiratory depressant effects of both techniques was assessed via continuous pulse oximetry. Results were analyzed using the chi 2 test, rank t test, and SD.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Propofol-fentanyl versus midazolam-fentanyl: a comparative study of local sedation techniques for cataract surgery. 147 88

The fifteen year long practice of loco-regional anaesthesia for cataract surgery has led, because its growing complexity (operating microscope, extra-capsular procedure, IOL) to improving neuroleptanalgesia. The actual step using a weak dose of Propofol is described. The akinesy of patient and eye permits that kind of surgery, well accepted without the risks of deep general anaesthesia with intubation.
 ...
PMID:[15-year evolution of loco-regional anesthesia for cataracts at a general hospital center]. 280 94

We compared the effects of the Brain laryngeal mask airway with a tracheal tube on intra-ocular pressure. Propofol was used as induction agent and atracurium as relaxant. Twenty-six patients with normal intra-ocular pressure undergoing cataract surgery were randomly allocated to two groups. Group A (n = 13) had a laryngeal mask airway inserted and Group B (n = 13) had a tracheal tube inserted. Intra-ocular pressure was measured just before insertion of the airway, 20 s after insertion and at 2 min. In the laryngeal mask airway group there were no significant changes in mean intra-ocular pressure. In the tracheal tube group there was a significant rise in mean intra-ocular pressure at 20 s (p = 0.0056) which returned to pre-insertion levels at 2 min. We conclude that the laryngeal mask airway continues to have advantages over the tracheal tube for ophthalmic surgery despite the use of propofol and atracurium as anaesthetic agents.
 ...
PMID:Intra-ocular pressure changes following laryngeal mask airway insertion: a comparative study. 929 69

Patient-controlled sedation (PCS) with propofol has been used successfully as an adjunct to local anaesthetic procedures. We studied a group of elderly patients (mean age 75.4 yr) undergoing cataract surgery and attempted to increase patient acceptability and comfort of local anaesthesia. Propofol was self-administered in a dose of 0.25 mg kg-1 for patients more than 60 yr of age, with a lockout period of 3 min. A total of 14 of 20 patients used PCS; eight of 20 used the PCS only once and another six had three tries or less. Despite this, 18 of 20 patients claimed they found the PCS useful. However, while it is possible to administer PCS successfully to elderly patients undergoing cataract surgery and produce a decrease in the level of anxiety, we found it unacceptable because of head movement in two patients. These patients received only two and three divided doses, to a maximum of 29 and 30 mg, respectively. There were no other adverse events.
 ...
PMID:Patient-controlled sedation using propofol in elderly patients in day-case cataract surgery. 1047 35

The short onset and offset of remifentanil may allow for accurate dosing of sedative effect with few side-effects and rapid recovery. In this study, remifentanil is compared with propofol for sedation intraocular pressure hemodynamics and oxygen saturation, in patients undergoing cataract surgery with peribulbar block. After ethical committee approval, fifty patients scheduled for one eye cataract surgery were enrolled into the prospective study. Remifentanil infusion was initialized at a rate of 0.04 microg/kg/min, 10 min before peribulbar anesthesia in Remifentanil group (Group R). In Propofol Group (Group P), propofol infusion of 2 mg/kg/h was reduced to 1mg/kg/h. Intraocular pressures of the contralateral eye were measured before and after peribulbar anesthesia and at the end of the operation. Sedation scores (1-5), hemodynamic parameters and saturation were assessed at 5 minute intervals. Heart rate, intraocular pressure, saturation and sedation scores were similar between groups. Intraocular pressures decreased within time in both groups. There were significant changes in mean blood pressure after 5th min between groups (P < 0.05). The infusion of remifentanil or propofol for sedation provided adequate sedation, hemodynamic stability without increasing intraocular pressure during surgery in patients undergoing cataract surgery with peribulbar anesthesia.
 ...
PMID:Remifentanil versus propofol sedation for peribulbar anesthesia. 1638 Dec 64