Effectiveness of sedation in dacryocystorhinostomy surgery.

BACKGROUND chronic dacryocystitis is a common ophthalmic problem almost always requiring surgery as the only definitive treatment. AIM to compare the perioperative outcome of external DCR surgery under local anesthesia with and without sedation. SUBJECTS AND METHODS one hundred consecutive patients with chronic dacryocystitis undergoing dacryocystorhinostomy (DCR) surgery were randomly divided into two groups using computer generated random table. Group A underwent DCR under local anesthesia (LA) without sedation and group B under LA with sedation. The outcome parameters were intra-operative pain, surgeon's comfort, intra-operative complications and duration of surgery. STATISTICAL ANALYSIS SPSS version 11.5 software was used. Chi square test was used to compare the difference between the groups. RESULTS there were 50 patients in each group. The mean age +/- SD of the patients was 34.4 +/- 12.12 years (95% CI=28.89-38.55 years). Sixty-nine percent of them were female. Significantly higher number of patients experienced pain in Group A as compared to Group B (100% vs 50%, P<0.001) Surgeon's discomfort was significantly present in group A as compared to group B (70% vs 10%), (p=0.00001). Blood loss was significantly more in group A than in group B (p=0.017). There was no significant difference in the duration of surgery. The post operative success rate in both the groups was comparable after six months of followup. CONCLUSION the use of sedation with LA improves the perioperative outcome of DCR surgery in terms of patient's pain, surgeon's comfort and intra-operative complications.