• Andrew J Erie, Ryan McHugh, Mary Warner, and Jay C Erie.
• Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA. erie.jay@mayo.edu
• J Cataract Refract Surg. 2011 Mar 1; 37 (3): 481-5.

PurposeTo determine the safety and practicality of a combined anesthesiologist and registered nurse model of anesthesia care in cataract surgery.SettingMayo Clinic, Rochester, Minnesota, USA.DesignCase series.MethodsThis retrospective review comprised consecutive patients having phacoemulsification cataract surgery and peribulbar injection anesthesia combined with propofol intravenous sedation between August 1, 2004, and July 31, 2006. In all cases, anesthesiologist-supervised intravenous propofol sedation during injection anesthesia was followed by registered nurse observation for the remainder of the surgery. Outcome measures were the rate of subsequent anesthesiologist intervention, intraoperative complications, and associated risk factors. Logistic regression models were used to estimate risk for anesthesiologist intervention.ResultsThe study reviewed 3656 cases. There were no serious medical complications leading to postoperative hospitalization. Fifty-four cases (1.5%) required subsequent intraoperative anesthesiologist intervention. Evaluation of systolic hypertension (40 of 54 cases, 74%) was the most common reason for anesthesiologist intervention. There was no correlation between anesthesiologist intervention and patient age or sex (P=.77 and P=.41, respectively). The risk for anesthesiologist intervention increased 2.2-fold for every 1 unit increase in the American Society of Anesthesiologists Physical Status score (P=.007).ConclusionThe monitoring of cataract surgery patients by registered nurses after anesthesiologist-supervised intravenous propofol sedation during injection anesthesia was associated with very low complication and anesthesiologist intervention rates.Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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