Dexmedetomidine premedication in cataract surgery under topical anaesthesia: to assess patient and surgeon satisfaction

Abstract

Background: Dexmedetomidine is a potent non-opioid analgesic that may enhance analgesia for cataract surgery under topical anaesthesia. This study was undertaken to assess sedation and analgesia provided by dexmedetomidine and evaluating patients’ satisfication. Secondary aims were: (1) To study the effect of dexmedetomidine in decreasing the intraocular pressure. (2) The impact on surgeons' satisfaction. (3) Hemodynamic effects
Methods: We conducted a prospective randomized study on ASA I/II patients presenting for cataract surgery under topical anesthesia. Patients were randomly assigned to two groups: group D received dexmedetomidine premedication 1 mcg/kg over 10 minutes and group C received saline at the same rate. Sedation and pain score, intraocular pressure, patient and surgeon satisfaction score and hemodynamics were monitored and compared.
Results: There was a significant increase in sedation assessed by the Ramsay sedation score at all times in group D after receiving dexmedetomidine (p< 0.0001). However, pain scores (numeric rating scale) were similar in both groups (p>0.05). Dexmedetomidine decreased the intraocular pressure and the difference was statistically highly significant (p< 0.0001). Group D had better patient and surgeon satisfaction score as against group C (p=0.0001). Noticably, the incidence of dry mouth was higher in group D. Hemodynamic parameters were well maintained in both groups with no adverse events in either group. 
Conclusions: Dexmedetomidine can be used safely for cataract surgery under topical anesthesia surgery. Administration of dexmedetomidine was associated with better patient and surgeon satisfaction.