Alfentanil sedation for oculoplastic surgery: the patient experience

PURPOSE: A number of agents have previously been reported to be safe and effective for sedation and analgesia in ophthalmic surgery under local anaesthesia, but there has been no previous patient-focused assessment of this form of conscious sedation. We present a patient satisfaction survey, including a validated pain score, for patients undergoing oculoplastic procedures under local anaesthesia with alfentanil sedation.

METHODS: A prospective, non-randomized, questionnaire-based study of the experience, satisfaction and pain scores of consecutive patients undergoing oculoplastic procedures under local anaesthesia with alfentanil sedation at University Hospital, Coventry, UK, under the care of one Consultant Oculoplastic Surgeon between 2006 and 2009.

RESULTS: Three hundred and sixty-seven patients were surveyed over the 3-year period. Overall, 52% were female and 89% of Caucasian ethnic origin. Mean duration of surgical procedures was 34 minutes (range 2-120 minutes). Over 90% of patients described a low pain score, both during the local anaesthetic injection and per-operatively, and 98% stated that they were happy to have this sedation technique for further oculoplastic surgery in future. Side effects related to sedation were reported in 5% of patients. There were no conversions to general anaesthesia and no day-case patients required an overnight in-patient stay.

CONCLUSION: Conscious sedation with alfentanil for oculoplastic procedures under local anaesthesia results in low pain scores and high patient satisfaction with minimal complications.