Dear Editor
We read with great interest the results of the pilot study comparing
patients satisfaction between topical and sub-Tenon’s anaesthesia.[1] In
conclusion the authors state that sub-Tenon’s block produces higher
satisfaction scores than topical anaesthesia.[1]
The scores used were obtained using the ISAS score, which has been
used many times during other forms of surgery.[2]
However, the ISAS has not been used in the setting of unmonitored
anaesthetic care and has not as yet been fully validated in a purely local
anaesthetic environment. Dexter, who was part of the team that developed
the ISAS, has said that the ISAS is still to be validated in this setting.
Therefore we would suggest that the conclusions that sub-Tenon’s gives
better satisfaction than topical, purely based on this scale, is slightly
premature.
The ISAS is due to be validated soon using local anaesthesia and
sedation [3] however it is still used specifically during monitored
anaesthetic care and is as yet not tested on unmonitored anaesthetic care
which is often found during topical cataract lists.
References
1. Rüschen H, Celaschi D, Bunce C, Carr C. Randomised controlled trial
of sub-Tenon’s block versus topical anaesthesia for cataract surgery: a
comparison of patient satisfaction. Br J Ophthalmol. 2005; 89: 291-293.
2. Dexter F. Aker J. Wright WA. Development of a measure of patient
satisfaction with monitored anesthesia care: the Iowa Satisfaction with
Anesthesia Scale.Anesthesiology. 87(4):865-73, 1997 Oct.
3. Fung D, Cohen M, Stewart S, Davies A. Can the Iowa Satisfaction
with Anesthesia Scale be used to measure patient satisfaction with
cataract care under topical local anesthesia and monitored sedation at a
community hospital? Anesthesia and Analgesia June 01, 2005; 100 (6).
Dear Editor
We read with great interest the results of the pilot study comparing patients satisfaction between topical and sub-Tenon’s anaesthesia.[1] In conclusion the authors state that sub-Tenon’s block produces higher satisfaction scores than topical anaesthesia.[1]
The scores used were obtained using the ISAS score, which has been used many times during other forms of surgery.[2]
However, the ISAS has not been used in the setting of unmonitored anaesthetic care and has not as yet been fully validated in a purely local anaesthetic environment. Dexter, who was part of the team that developed the ISAS, has said that the ISAS is still to be validated in this setting. Therefore we would suggest that the conclusions that sub-Tenon’s gives better satisfaction than topical, purely based on this scale, is slightly premature.
The ISAS is due to be validated soon using local anaesthesia and sedation [3] however it is still used specifically during monitored anaesthetic care and is as yet not tested on unmonitored anaesthetic care which is often found during topical cataract lists.
References
1. Rüschen H, Celaschi D, Bunce C, Carr C. Randomised controlled trial of sub-Tenon’s block versus topical anaesthesia for cataract surgery: a comparison of patient satisfaction. Br J Ophthalmol. 2005; 89: 291-293.
2. Dexter F. Aker J. Wright WA. Development of a measure of patient satisfaction with monitored anesthesia care: the Iowa Satisfaction with Anesthesia Scale.Anesthesiology. 87(4):865-73, 1997 Oct.
3. Fung D, Cohen M, Stewart S, Davies A. Can the Iowa Satisfaction with Anesthesia Scale be used to measure patient satisfaction with cataract care under topical local anesthesia and monitored sedation at a community hospital? Anesthesia and Analgesia June 01, 2005; 100 (6).