title: [Simplified topical anesthesia protocol for ambulatory cataract surgery: safety and patient and surgeon satisfaction].
abstract: OBJECTIVE
  The purpose of our study was to assess safety and efficacy of cataract surgery (CS) under topical anesthesia alone, i.e. without pre-anesthetic evaluation and without direct presence of an anesthesiologist. To this end we assessed the incidence of patients' preoperative anxiety, perioperative adverse events and patients' and surgeons' satisfaction.
  
  
  METHODS
  Patients undergoing CS under topical anesthesia over a one-month period were included. An anesthesiologist and nurse anesthetist were present in the area and could intervene in case of an adverse event. Patients' anxiety was scored using the Amsterdam Preoperative Anxiety & Information Scale (APAIS), and their satisfaction with the Iowa Satisfaction with Anesthesia Scale (ISAS). Surgeons' satisfaction was scored with a VAS from 0 to 10 (0: surgery not possible & 10: excellent surgical conditions).
  
  
  CONCLUSIONS
  One hundred and twenty-four consecutive patients were included; mean age was 71 (±9.4) years. Mean APAIS I was 6.4/20 (±3.7). Mean APAIS II was 3.1 (±1.8). Mean ISAS score was 5.5/6 (±0.6), indicating high patient satisfaction. Surgeon satisfaction score was 8.9/10 (±1.7). Twenty-three adverse events occurred of which 16 required interventions by the anaesthesiologist or surgeon: 5 supplemental local or regional anaesthesia, 6 iv-analgesia, 5 management of hypertension.
  
  
  CONCLUSIONS
  These preliminary data suggest that a simplified topical anesthesia protocol for ambulatory CS appears to be feasible and safe, as long as an anesthesia team is present in the area to intervene if needed.
authors.affiliation: Département d'ophtalmologie, CHU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Batta
authors.affiliation: Département d'anesthésie-réanimation, CHU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France.
authors.forename: T
authors.initials: T
authors.lastname: Fuchs-Buder
authors.affiliation: Département d'ophtalmologie, CHU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Tréchot
authors.affiliation: Département d'ophtalmologie, CHU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France. Electronic address: k.angioi-duprez@chu-nancy.fr.
authors.forename: K
authors.initials: K
authors.lastname: Angioi
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001007:Anxiety / Q000175:diagnosis; D001291:Attitude of Health Personnel; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011300:Preoperative Care; D011343:Procaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000779:Anesthetics, Local; D011343:Procaine; C005298:benoxinate
keywords: Anesthesia preoperative evaluation; Anesthésie topique; Cataract surgery; Cataracte; Consultation d’anesthésie; Topical anesthesia