A systematic review and meta-analysis of intravenous sedation in modern cataract surgery
What:
Paper Presentation | Présentation d'article
When:
4:26 PM, Saturday 2 Jun 2018
(3 minutes)
Where:
How:
Authors: William Hodge, Effie Kiatos, Monali Malvankar-Mehta, Cindy Hutnik
Author Disclosure Block: W. Hodge: None. E. Kiatos: None. M. Malvankar-Mehta: None. C. Hutnik: None.
Abstract Body:
Purpose: The purpose of this systematic review and meta-analysis is to assess the effectiveness of phacoemulsification with intravenous sedation versus non-intravenous sedation techniques.
Study Design: A Systematic Review and Meta-Analysis.
Methods: The search strategy was performed with the help of an information specialist. A two level screening process was undertaken. Results were done in duplicate with the help of Covedence software. Only RCTs were used in the final analysis. Ten studies made all inclusion criteria and screening sequences.
Results: Results of the meta-analysis found that intravenous sedation was significantly associated with a decrease in pain (SMD = -0.86 with 95% CI of -1.49 to -0.23, p=0.0008) (WMD = -1.01 with 95% CI of -1.66 to -0.36, p=0.002). The weighted mean difference can be interpreted as a 10.1% decrease in pain. The subgroup analysis found patients did not have a statistically significant reduction in pain when using intravenous sedation over oral sedation (SMD =0.02, 95% CI -0.23 to 0.27, p=0.871). The meta-analysis of adverse events found that intravenous sedation did not have a statistically significant increase in adverse events when compared to non-intravenous anesthesia techniques (RR=0.99, 95% CI 0.97 to 1.02, p=0.704).
Conclusions: Although IV sedation reduces patient's perception of pain compared to no IV sedation, the subgroup analysis showed that oral sedation was equally effective. This has implications for manpower needed for cataract surgery and may save significant dollars for the health care system.
Author Disclosure Block: W. Hodge: None. E. Kiatos: None. M. Malvankar-Mehta: None. C. Hutnik: None.
Abstract Body:
Purpose: The purpose of this systematic review and meta-analysis is to assess the effectiveness of phacoemulsification with intravenous sedation versus non-intravenous sedation techniques.
Study Design: A Systematic Review and Meta-Analysis.
Methods: The search strategy was performed with the help of an information specialist. A two level screening process was undertaken. Results were done in duplicate with the help of Covedence software. Only RCTs were used in the final analysis. Ten studies made all inclusion criteria and screening sequences.
Results: Results of the meta-analysis found that intravenous sedation was significantly associated with a decrease in pain (SMD = -0.86 with 95% CI of -1.49 to -0.23, p=0.0008) (WMD = -1.01 with 95% CI of -1.66 to -0.36, p=0.002). The weighted mean difference can be interpreted as a 10.1% decrease in pain. The subgroup analysis found patients did not have a statistically significant reduction in pain when using intravenous sedation over oral sedation (SMD =0.02, 95% CI -0.23 to 0.27, p=0.871). The meta-analysis of adverse events found that intravenous sedation did not have a statistically significant increase in adverse events when compared to non-intravenous anesthesia techniques (RR=0.99, 95% CI 0.97 to 1.02, p=0.704).
Conclusions: Although IV sedation reduces patient's perception of pain compared to no IV sedation, the subgroup analysis showed that oral sedation was equally effective. This has implications for manpower needed for cataract surgery and may save significant dollars for the health care system.
