Patient-controlled sedation vs. anaesthetic nurse-controlled sedation for cataract surgery in elderly patients.
BACKGROUND
Patient-controlled sedation (PCS) with propofol has been used successfully in various conditions, but controversies exist about its use in sedation of elderly patients for cataract surgery. This study evaluates the efficacy of anaesthetic nurse-controlled sedation (ACS) compared with PCS using the same device and the drug.


METHODS
All of the 153 elderly patients (aged 51-88 years) undergoing cataract surgery with a sub-Tenon's infiltration were assigned to receive ACS (n = 51) or PCS (n = 51) with propofol or no intra-operative sedation (control, n = 51). Propofol was administered with a bolus dose of 10 mg and a lockout interval of 1 min. Cognitive function, sedation, pain, anxiety, side effects and satisfaction of patients were evaluated.


RESULTS
The mean +/- SD doses of propofol administered were 34.9 +/- 8.8 mg and 30.1 +/- 30.4 mg in the groups ACS and PCS, respectively. The anxiety score was lower in both ACS and PCS groups compared with control group but was not different between the two groups. Patient's satisfaction was highest in PCS group, ACS group was the next, compared with non-sedated group. Other parameters were not different among the three groups.


CONCLUSIONS
Both ACS and PCS using propofol provided reduced anxiety compared with control, but patient's satisfaction was higher in the PCS group compared with ACS group.
Yun
M J
MJ
Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Sungnamsi, Kyonggido, Korea.
Oh
A Y
AY
Kim
K O
KO
Kim
Y H
YH
D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000517:prevention & control; D002387:Cataract Extraction; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage; D012646:Self Administration; D016037:Single-Blind Method
D006993:Hypnotics and Sedatives; D015742:Propofol