title: Assessing the quality of ophthalmic anesthesia.
abstract: OBJECTIVE
  The study objective is to evaluate a scoring system to assess the quality of anesthesia used in ophthalmic surgery.
  
  
  METHODS
  This is an observational prospective study.
  
  
  METHODS
  The setting is at an operating theater.
  
  
  METHODS
  Patients are all patients undergoing ophthalmic surgery, October 2012.
  
  
  METHODS
  Quality of ophthalmic anesthesia was measured using an interval scale by the operating surgeon. Parameters were graded depending on the type and route of anesthetic: central eye position, anesthesia, akinesia of the eye and or body, soft tissue or orbital hemorrhage, and absence of vitreous bulge.
  
  
  METHODS
  The measurements are quality score and proportion of optimal and suboptimal cases of anesthesia and number of surgical complications.
  
  
  RESULTS
  Data were collected on 349 consecutive cases including cataract (55%), retinal (14%), corneal transplant (6%), and strabismus surgery (6%). Sub-Tenon was the most commonly performed (31%) followed by peribulbar (PB) (26%), general anesthesia (GA) (20%), topical (17%), and retrobulbar (RB) (6%) anesthesia. There were 11 surgical complications: posterior capsule rupture (7), dislocated lens (2), and orbital hemorrhage (2). Sub-Tenon had lower quality scores than PB (P = .006), RB (P = .028), and GA (P <.001); and PB and RB had lower scores than GA (P < .01). There was a significant association between suboptimal anesthesia and surgical complications (P < .001), odds ratio = 3.94 (95% confidence interval, 1.03-15.12; P = .046).
  
  
  CONCLUSIONS
  The quality of ophthalmic anesthesia is an important component of the surgical procedure and should be considered in any risk stratification. Suboptimal anesthesia is associated with an increased rate of surgical complications.
authors.affiliation: St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Road, Liverpool, Merseyside, L7 8XP, UK. Electronic address: nax024@gmail.com.
authors.forename: Natasha
authors.initials: N
authors.lastname: Spiteri
authors.affiliation: St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Road, Liverpool, Merseyside, L7 8XP, UK.
authors.forename: Gediminas
authors.initials: G
authors.lastname: Sidaras
authors.affiliation: University of Liverpool, Liverpool, Merseyside, L69 3BX, UK.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Czanner
authors.affiliation: St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Road, Liverpool, Merseyside, L7 8XP, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Batterbury
authors.affiliation: St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Road, Liverpool, Merseyside, L7 8XP, UK; University of Liverpool, Liverpool, Merseyside, L69 3BX, UK.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kaye
mesh_terms: D000758:Anesthesia / Q000379:methods*; D000777:Anesthetics / Q000008:administration & dosage*; D006801:Humans; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies
chemical_list: D000777:Anesthetics
keywords: Anesthesia; Cataract; Ophthalmology