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document
Comparison of sedative drugs under peribulbar or topical anesthesia during phacoemulsification . BACKGROUND AND OBJECTIVE To compare dexmedetomidine and midazolam+fentanyl sedation primarily based on patient satisfaction during phacoemulsification under topical and peribulbar anesthesia . PATIENTS AND METHODS Prospective , randomized , and double-blind study of 80 American Society of Anesthesiology grade I-II patients who underwent phacoemulsification with local anesthesia under sedation . Patients were divided into four groups ( 20 patients for each ) : dexmedetomidine and topical anesthesia , dexmedetomidine and peribulbar anesthesia , midazolam+fentanyl and topical anesthesia , and midazolam+fentanyl and peribulbar anesthesia . Patient and surgeon satisfaction were determined on a 5-point scale . The pain was determined by verbal pain scale intraoperatively and postoperatively . Drugs were given to a Ramsay sedation scale of 3 . Topical and peribulbar anesthesia were performed by an ophthalmologist . Hemodynamic , respiratory , and intraocular pressure monitoring was done . Operative and recovery times were recorded . RESULTS In the midazolam+fentanyl groups , better patient and surgeon satisfaction scores were obtained ( P < .005 ) , verbal pain scale scores were significantly lower ( P < .001 ) , and patients needed less postoperative analgesia . Ramsay sedation scale scores were between 3 and 4 in all patients and there were no significant differences . Intraocular pressure alterations were similar between groups . Recovery time was longer in the dexmedetomidine groups ( P < .05 ) . CONCLUSION The study demonstrated that the midazolam+fentanyl combination provided high-level patient satisfaction scores , low-level pain scores , and shorter recovery time . Also , both of the peribulbar and topical anesthesia procedures showed similar efficiency .
53658
Intervention_Pharmacological
sedative drugs
53659
Intervention_Pharmacological
dexmedetomidine
53660
Intervention_Pharmacological
midazolam+fentanyl sedation
53661
Intervention_Pharmacological
dexmedetomidine
53662
Intervention_Pharmacological
topical anesthesia
53663
Intervention_Pharmacological
dexmedetomidine
53664
Intervention_Pharmacological
peribulbar anesthesia
53665
Intervention_Pharmacological
midazolam+fentanyl
53666
Intervention_Pharmacological
topical anesthesia
53667
Intervention_Pharmacological
midazolam+fentanyl
53668
Intervention_Pharmacological
peribulbar anesthesia
53669
Intervention_Pharmacological
midazolam+fentanyl
53670
Intervention_Pharmacological
midazolam+fentanyl combination
53671
Outcome_Other
patient and surgeon satisfaction scores
53672
Outcome_Pain
verbal pain scale scores
53673
Outcome_Other
postoperative analgesia
53674
Outcome_Other
Ramsay sedation scale scores
53675
Outcome_Physical
Intraocular pressure alterations
53676
Outcome_Other
Recovery time
53677
Outcome_Other
patient satisfaction scores
53678
Outcome_Pain
pain scores
53679
Outcome_Other
recovery time
53680
Participant_Condition
phacoemulsification
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Participant_Sample-size
80
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Participant_Sample-size
20