Adult strabismus surgery under propofol sedation with local versus general anesthesia.
OBJECTIVE
To compare operating room and hospital discharge times between adult strabismus surgeries using intravenous propofol sedation with local anesthesia versus those using general anesthesia.


METHODS
Thirty adult patients underwent uncomplicated strabismus procedures performed by one surgeon using propofol sedation and local subtenon's anesthesia. These were retrospectively matched with adult patients undergoing similar procedures by another surgeon using general inhalational anesthesia. Only one muscle had undergone previous surgery, and no adjustable sutures were used. Times from incision closure to leaving the operating room (Out OR time), and to hospital discharge (DC time) are compared.


RESULTS
Propofol/local Out OR times ranged 2 to 8 minutes (mean, 4.8). General anesthesia Out OR times ranged from 3 to 28 minutes (mean, 8.8) (means differ at P<.001). At 10 minutes, 100% of propofol patients left the OR, but only 63% of general patients had done so (P<.001). Propofol/local DC times ranged from 30 to 140 minutes (mean, 64.8). General DC times ranged from 68 to 325 minutes (mean 116.5) (means differ at P<.001). At 60 minutes after completion of surgery, 53% of propofol/local patients had left the hospital, whereas none of general patients had left (P<.001). At 2.5 hours after surgery, 100% of propofol/local patients had left the hospital, but 10% of general patients remained, with two staying more than 5 hours.


CONCLUSIONS
Many adult strabismus surgeries may be performed more efficiently with intravenous propofol sedation and local subtenon's anesthesia than with general anesthesia. Times from the end of surgery to leaving both the OR and the hospital are decreased compared with those of general anesthesia. Extreme delays are rare with propofol/local, but they occurred with general anesthesia.
Eye Consultants of Atlanta, Atlanta, GA, USA.
Marc F
MF
Greenberg
Zane F
ZF
Pollard
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D000772:Anesthesia, Local; D016292:Procedural Sedation; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007275:Injections, Intravenous; D015993:Life Tables; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage; D013285:Strabismus / Q000601:surgery*; D013997:Time Factors
D006993:Hypnotics and Sedatives; D015742:Propofol