Structured assessment tool to evaluate patient suitability for cataract surgery under local anaesthesia.
BACKGROUND
Cataract extraction and intraocular lens implantation is a common surgical procedure. While the vast majority of these operations are performed under local anaesthesia (LA), this is not an appropriate technique for every patient. Likewise it is time-consuming to assess all patients fitness for general anaesthesia when most will not need it.


METHODS
We developed an eight-item questionnaire that can be administered before admission to assess patient suitability for surgery under LA. In a prospective study over a 9-month period, 128 patients were seen in a pre-admission clinic, and according to the responses to the questionnaire administered by junior medical staff, 123 were deemed suitable for surgery under LA, and five under general anaesthetic (GA).


RESULTS
All 123 patients went on to have surgery successfully performed under LA. A further two patients from the GA group were determined by the attending anaesthetist to be suitable for surgery under LA.


CONCLUSIONS
This assessment instrument has been shown to be a highly specific means of selecting patients for surgery under LA, and can be administered by medical or nursing staff.
Department of Anaesthesia and Pain Management, Royal North Shore Hospital, St Leonards, NSW 2065, Australia. rmacpher@doh.health.nsw.gov.au
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MacPherson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D000772:Anesthesia, Local; D002387:Cataract Extraction; D000075202:Contraindications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires