Sedation during vitreoretinal surgery: practice patterns in Canada
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Sedation during vitreoretinal surgery: practice patterns in Canada Scott McCusker, MD . Varun Chaudhary, MD . Philip Blew, MD . Michael Mak, BHSc . Joshua Barbosa, BHSc . Jenny Qian, MD . Harsha Shanthanna, MD . Tania Ligori, MD
Received: 12 February 2020 / Revised: 17 April 2020 / Accepted: 18 April 2020 Ó Canadian Anesthesiologists’ Society 2020
To the Editor, Most ophthalmic surgeries are performed under monitored anesthesia care (MAC) using procedural sedation.1 Achieving optimal sedation during pars planar vitrectomy (PPV) is critical as there are potential consequences associated with under- or over-sedation; either state may result in sudden movements due to periodic abrupt wakening with resulting eye injury and blindness. As ophthalmic surgery is increasingly performed in ambulatory surgical centres, anesthesiology residents may have limited exposure to procedural sedation for these surgeries. We undertook this survey to understand current sedation practice for PPV among Canadian academic anesthesiologists and identify opportunities for further research and education. The survey was approved by Hamilton Integrated Research Ethics Board (4 January 2017). This nationwide anonymous web-based survey was developed by the primary author in discussion with two anesthesiologists,
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-020-01689-2) contains supplementary material, which is available to authorized users. S. McCusker, MD (&) P. Blew, MD H. Shanthanna, MD T. Ligori, MD Department of Anesthesia, McMaster University, Hamilton, ON, Canada e-mail: [email protected] V. Chaudhary, MD J. Barbosa, BHSc J. Qian, MD Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, ON, Canada M. Mak, BHSc Division of Ophthalmology, Department of Surgery, University of Calgary, Calgary, AB, Canada
but was not piloted. Invitations to participate were distributed by the Canadian Anesthesiologists’ Society. The questionnaire (eAppendix, available as an Electronic Supplementary Material) investigated the practice patterns of Canadian anesthesiologists regarding sedation during regional block and the PPV procedure, as well as exposure of Canadian anesthesia residents to PPV. Surveys were sent in two waves (one initial mail on 13 March 2018 and one follow-up reminder on 9 April 2018). Inclusion criteria were practicing staff anesthesiologists and anesthesia residents in training at Canadian academic centres. Respondents were excluded if they answered no to the following questions: ‘‘Are you an anesthesiologist staff or resident?’’ and ‘‘Are you an anesthesiologist at a Canadian academic centre who performs sedation for PPV procedures?’’ In total, there were 374 respondents from 2,427 emails (15.4%); staff and resident response rates were 338/1835 (8.4%) and 30/593 (5%), respectively. After excluding staff anesthesiologists who did not perform sedation for vitrectomy, we analyzed data from 127 staff and 30 resident responses
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