TY - JOUR
T1 - International variation in anesthesia care during cataract surgery
T2 - Results from the international cataract surgery outcomes study
AU - Nørregaard, Jens Christian
AU - Schein, Oliver D.
AU - Bellan, Lome
AU - Black, Charlyn
AU - Alonso, Jordi
AU - Bernth-Petersen, Peter
AU - Dunn, Elaine
AU - Andersen, Tavs Folmer
AU - Espallargues, Mireia
AU - Anderson, Gerard F.
PY - 1997
Y1 - 1997
N2 - Objectives: To describe international variation in anesthesia care and monitoring during cataract surgery and to discuss its implications for cost and safety. Methods: A standardized questionnaire was sent to random samples of ophthalmologists in the United States. Canada, and Barcelona, Spain, and to all ophthalmologists in Denmark. The survey was conducted in 1993 and 1994. Certified ophthalmologists who had performed 1 or more cataract extractions in the previous year were eligible for enrollment. Results: The response rates were 62% in the United States (n=148), 67% in Canada (n=276), 70% in Barcelona (n=89), and 80% in Denmark (n=82). The anesthetic technique for cataract surgery varied significantly between sites (P<.001). Surgeons reported that retrobulbar blocks were used for 46% of the cataract extractions in the United States, 70% in Canada. 66% in Denmark, and 31% in Barcelona. In Barcelona, general anesthesia was used for 23% of the cataract extractions; it was used for less than 3% of the extractions at the other 3 sites. Peribulbar blocks or topical anesthesia was used for the remaining extractions. In the United States, Canada, and Barcelona, surgeons reported that vital functions were monitored during more than 97% of the extractions and anesthesia surveillance was used during more than 78% of the extractions. In Denmark, ophthalmologists reported that vital functions were monitored and anesthesia surveillance was used for 1% of the cataract extractions (P<.001). Conclusions: Substantial international variation in anesthesia care and monitoring during cataract surgery was observed. The findings suggest a need for further research to determine whether less intensive monitoring is cost- effective.
AB - Objectives: To describe international variation in anesthesia care and monitoring during cataract surgery and to discuss its implications for cost and safety. Methods: A standardized questionnaire was sent to random samples of ophthalmologists in the United States. Canada, and Barcelona, Spain, and to all ophthalmologists in Denmark. The survey was conducted in 1993 and 1994. Certified ophthalmologists who had performed 1 or more cataract extractions in the previous year were eligible for enrollment. Results: The response rates were 62% in the United States (n=148), 67% in Canada (n=276), 70% in Barcelona (n=89), and 80% in Denmark (n=82). The anesthetic technique for cataract surgery varied significantly between sites (P<.001). Surgeons reported that retrobulbar blocks were used for 46% of the cataract extractions in the United States, 70% in Canada. 66% in Denmark, and 31% in Barcelona. In Barcelona, general anesthesia was used for 23% of the cataract extractions; it was used for less than 3% of the extractions at the other 3 sites. Peribulbar blocks or topical anesthesia was used for the remaining extractions. In the United States, Canada, and Barcelona, surgeons reported that vital functions were monitored during more than 97% of the extractions and anesthesia surveillance was used during more than 78% of the extractions. In Denmark, ophthalmologists reported that vital functions were monitored and anesthesia surveillance was used for 1% of the cataract extractions (P<.001). Conclusions: Substantial international variation in anesthesia care and monitoring during cataract surgery was observed. The findings suggest a need for further research to determine whether less intensive monitoring is cost- effective.
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U2 - 10.1001/archopht.1997.01100160474016
DO - 10.1001/archopht.1997.01100160474016
M3 - Article
C2 - 9338678
AN - SCOPUS:9844269578
VL - 115
SP - 1304
EP - 1308
JO - JAMA Ophthalmology
JF - JAMA Ophthalmology
SN - 2168-6165
IS - 10
ER -