Publication:

Assessing intravenous midazolam for conscious sedation during cataract surgery

Background A large number of geriatric populations above the age of 50 worldwide suffer from cataract. Cataract starts with short-sightedness and gradually worsens resulting in blurring of vision and inability to visualize and distinguish fine details. Surgery is the only available treatment for cataract. Anaesthesia is essential during cataract surgery to minimize pain caused during surgical procedure and to achieve favourable surgical outcome. The current investigation was aimed towards assessing the performance of intravenous midazolam used for conscious sedation during cataract surgery along with retrobulbar block.

Methods Current study is a randomized double blinded study performed for duration of 6 months on 60 patients undergoing cataract surgery at Terna medical college and hospital. Patients were divided in two groups; group M received 0.02 mg/kg midazolam diluted to 5 ml, group N received 5 ml normal saline before cataract surgery. All vital hemodynamic parameters were observed after 5 minutes of sedation, immediately after block administration and after every 15 minutes till the end of the surgery to assess the effect of sedation. Patients and surgeons satisfaction levels were also documented post-surgery.

Results Patients who were sedated with midazolam prior to cataract surgery along with block exhibited a significant decrease in hemodynamic parameters like SAP, DAP and heart rate which indicated effective sedation. Anxiety level also significantly decreased in the patients who received midazolam. No major adverse or intra-operative events were observed in the patients who received midazolam.

Conclusions Sedation with midazolam provides haemodynamic conditions favourable for cataract surgery along with high level of patient and surgeon satisfaction.