Work

In Response

Year: 2018

Type: letter

Abstract: In Response We appreciate the opportunity to respond to comments made by Palte1 about our recent manuscript, which described our recommendation to use the least invasive form of anesthesia that is appropriate for the patient during cataract surgery.2 Specifically, cataract operations performed under topical anesthesia may have fewer complications than those performed under needle-based eye blocks, such as peribulbar and retrobulbar blocks.2 We agree with Palte1 and reported that there may be surgeon and patient preferences, patient factors and comorbidities, or case-specific factors that could make an eye block preferable to topical anesthesia for a specific case.2 However, in the absence of factors that would lead to a preference for eye blocks, we believe that a less invasive form of anesthesia (eg, topical anesthesia) should be used.2 Due to the continued need for eye blocks for certain cases, we recommended that anesthesiologists who perform eye blocks should have adequate and documented training.2 Palte1 suggested a few strategies that could achieve this: incorporating a minimum required number of eye blocks in anesthesia residency training programs, as we do for neuraxial anesthesia; and postgraduate preceptorships or workshops. We agree that either (or both) of these strategies would be a good start. We would add that any postgraduate training should include 1-on-1 observation and evaluation of eye block technique by well-trained and experienced providers. Karen C. Nanji, MD, MPHDepartment of Anaesthesia, Critical Care and Pain MedicineHarvard Medical SchoolMassachusetts General HospitalBoston, Massachusetts[email protected] Barbara Fain, JD, MPPBetsy Lehman Center for Patient SafetyBoston, Massachusetts Michael G. Morley, MD, ScMDepartment of OphthalmologyHarvard Medical SchoolBoston, MassachusettsOphthalmic Consultants of BostonBoston, Massachusetts Joseph Bayes, MDDepartment of AnesthesiaMassachusetts Eye & EarDepartment of AnaesthesiaHarvard Medical SchoolBoston, Massachusetts

Source: Anesthesia & Analgesia

DOI: 10.1213/ane.0000000000003872

Authors: Karen C. Nanji, Barbara Fain, Michael G. Morley, Joseph Bayes

Institutions: Harvard University, Massachusetts General Hospital, Ophthalmic Consultants of Boston, Massachusetts Eye and Ear Infirmary

Language: English

Topic: Anesthesia and Pain Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funder: Agency for Healthcare Research and Quality