The StarvAnx Study-Comparison Between the Effects of Non-fasting Vs. Fasting Strategy on Surgical Outcomes, Anxiety and Pain in Patients Undergoing Cataract Surgery Under Topical Anesthesia: A Randomized, Crossover, Controlled Trial.
anxiety
cataract surgery
pain
pre-operative fasting
surgical difficulty
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
08
04
2022
accepted:
22
06
2022
entrez:
1
8
2022
pubmed:
2
8
2022
medline:
2
8
2022
Statut:
epublish
Résumé
Fasting is usually recommended in patients undergoing cataract surgery under topical anesthesia. However, starving before surgery may increase preoperative anxiety and affect surgical outcomes. It is not known which fasting or non-fasting strategy is best for cataract surgery. The aim of this study was to compare non-fasting and fasting strategy in patients undergoing cataract surgery under topical anesthesia with regard to surgical outcomes, anxiety and pain. This randomized, crossover, controlled trial enrolled patients undergoing surgery for bilateral cataract under topical anesthesia at Cochin Hospital (Paris, France), from February to May 2021. Patients were randomly assigned to the non-fasting or fasting group for the first eye surgery and were switched to the other group for the second eye surgery. The primary endpoint was to compare the rate of anesthetist's interventions during surgery. The secondary endpoints included intra-operative complications, duration of surgery, surgeon perception of surgical difficulty, anesthesia-related complications and anxiety and pain level. one hundred and nine consecutive patients were included, with 60 of them being fasted first and non-fasted for the second eye surgery, while the other 59 were non-fasted first and fasted for the next surgery. The number of patients requiring sedation was significantly lower in the non-fasting group compared with the fasting group [1%; 95%IC (0-3.2) vs. 6%; 95%IC (2.9-8.9), In conclusion pre-operatory non-fasting strategy provides a better patient experience with regards to preoperative anxiety and surgical pain. It allows to reduce operating times and is safe and well-tolerated as regards the anesthetic intervention.
Sections du résumé
Background
UNASSIGNED
Fasting is usually recommended in patients undergoing cataract surgery under topical anesthesia. However, starving before surgery may increase preoperative anxiety and affect surgical outcomes. It is not known which fasting or non-fasting strategy is best for cataract surgery. The aim of this study was to compare non-fasting and fasting strategy in patients undergoing cataract surgery under topical anesthesia with regard to surgical outcomes, anxiety and pain.
Methods
UNASSIGNED
This randomized, crossover, controlled trial enrolled patients undergoing surgery for bilateral cataract under topical anesthesia at Cochin Hospital (Paris, France), from February to May 2021. Patients were randomly assigned to the non-fasting or fasting group for the first eye surgery and were switched to the other group for the second eye surgery. The primary endpoint was to compare the rate of anesthetist's interventions during surgery. The secondary endpoints included intra-operative complications, duration of surgery, surgeon perception of surgical difficulty, anesthesia-related complications and anxiety and pain level.
Results
UNASSIGNED
one hundred and nine consecutive patients were included, with 60 of them being fasted first and non-fasted for the second eye surgery, while the other 59 were non-fasted first and fasted for the next surgery. The number of patients requiring sedation was significantly lower in the non-fasting group compared with the fasting group [1%; 95%IC (0-3.2) vs. 6%; 95%IC (2.9-8.9),
Conclusion
UNASSIGNED
In conclusion pre-operatory non-fasting strategy provides a better patient experience with regards to preoperative anxiety and surgical pain. It allows to reduce operating times and is safe and well-tolerated as regards the anesthetic intervention.
Identifiants
pubmed: 35911419
doi: 10.3389/fmed.2022.916225
pmc: PMC9326043
doi:
Types de publication
Journal Article
Langues
eng
Pagination
916225Informations de copyright
Copyright © 2022 Guerrier, Bernabei, Giannaccare, Vagge, Bonnet, Baillard, Monnet and Rothschild.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Arch Ophthalmol. 1993 Jun;111(6):831-6
pubmed: 8512486
Br J Ophthalmol. 2004 Oct;88(10):1310-4
pubmed: 15377557
Anesthesiology. 2018 Mar;128(3):437-479
pubmed: 29334501
Ann Emerg Med. 2014 Feb;63(2):247-58.e18
pubmed: 24438649
Br J Ophthalmol. 2012 May;96(5):614-8
pubmed: 22133988
J Cataract Refract Surg. 2021 Mar 1;47(3):373-378
pubmed: 33086294
Anesth Analg. 2018 Dec;127(6):1448-1451
pubmed: 29863606
Ophthalmic Epidemiol. 2021 Aug;28(4):337-348
pubmed: 33225790
Am J Transl Res. 2021 Nov 15;13(11):13067-13075
pubmed: 34956525
Pain Res Treat. 2014;2014:827659
pubmed: 25050180
Ann Transl Med. 2020 Nov;8(22):1541
pubmed: 33313286
Anesth Analg. 2014 Jun;118(6):1317-25
pubmed: 24384865
Br J Anaesth. 2019 Dec;123(6):e526-e528
pubmed: 31540667
Curr Eye Res. 2021 Jul;46(7):971-977
pubmed: 33249933
J Cataract Refract Surg. 2000 Jan;26(1):109-13
pubmed: 10646156
Clin Exp Ophthalmol. 2020 Jul;48(5):593-601
pubmed: 32220125
Anesth Analg. 2001 Nov;93(5):1344-50
pubmed: 11682427
J Coll Physicians Surg Pak. 2019 Sep;29(9):868-873
pubmed: 31455484
Int J Environ Res Public Health. 2020 Jun 22;17(12):
pubmed: 32580413