Patient comfort and surgeon satisfaction during cataract surgery using topical anesthesia with or without dexmedetomidine sedation

PURPOSE. To determine the safety and efficacy of perioperative dexmedetomidine (Dex) sedation on patient comfort and surgeon satisfaction during cataract surgery under topical anesthesia. METHODS. Forty-four patients having routine clear corneal phacoemulsification surgery under topical anesthesia were included in the study. Patients were randomly divided into two groups: Dex group (n= 22) and control group ( n= 22). Patients in the Dex group were to receive intravenous Dex using an infusion pump and those in the control group were to receive 0.9% saline infusion. Primary outcome measures were patient comfort, surgeon satisfaction, and patient pain perception. RESULTS. There was no significant difference between the groups in terms of baseline characteristics including age, sex, eye side, pupil diameter, and vital signs (p > 0.05 for all). Patient comfort and surgeon satisfaction in Dex group was better than in control group (p= 0.042 and p= 0.003, respectively). The mean pain perception score was lesser in the Dex group (1.23 +/- 1.72) than control group (3.64 +/- 1.43), (p < 0.001). The mean surgical time and intraoperative complications were similar in both groups (p > 0.05). There was no significant effect of the Dex sedation on vital signs perioperatively (p > 0.05 for all). CONCLUSIONS. Dex sedation improved patient and surgeon satisfaction and decreased patients' pain perception while undergoing cataract surgery under topical anesthesia. It appears to be a safe and suitable choice of sedation for cataract surgery.