• L Bouvet, A-L Calderon, C Augris-Mathieu, N Diot-Junique, M-P Benoit, E Boselli, J Fleury, C Burillon, and B Allaouchiche.
• Service d'anesthésie-réanimation, pavillon C, groupement hospitalier Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France. Electronic address: lionel.bouvet@chu-lyon.fr.
• J Fr Ophtalmol. 2015 Apr 1;38(4):316-21.

ObjectivesThe current demographic situation in France regarding anesthesiologists calls for a reconsideration of anesthesia management for patients undergoing cataract surgery under topical anesthesia. This prospective observational study aimed to assess the requirement for anesthesiologist intervention during cataract surgery performed under topical anesthesia.Patients And MethodsPatients operated between November 2, 2011 and July 31, 2012 were included after indication of topical anesthesia for phacoemulsification proposed by the surgeon and confirmed by the anesthesiologist. Each patient was premedicated. All patients were monitored and supervised during the surgery by a nurse anesthesiologist. An anesthesiologist could be called at any time at the request of the surgeon or nurse anesthesiologist. For each patient, medical histories were recorded as well as the event "anesthesiologist called", along with the reason and the treatment performed.ResultsFive hundred and seventy-five phacoemulsifications were performed in 486 patients. The event "anesthesiologist called" was recorded 20 times: 18 times for hypertension, once for anxiety and once for non-emergent conversion to general anesthesia after a surgical complication. Each episode of hypertension was successfully treated by following the nicardipine protocol. Preoperatively uncontrolled hypertension was the only significant predictive risk factor for anesthesiologist requirement.ConclusionsThese results question the usefulness of preoperative anesthesia consultation for all patients who underwent phacoemulsification under topical anesthesia, since this consultation does not lead to an anesthesiologist service. Intraoperative medical complications may be treated according to medical protocols developed jointly by surgeons and anesthesiologists. This practice may free up anesthesiologists' time, without compromising patient safety.Copyright © 2015 Elsevier Masson SAS. All rights reserved.

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