Clinical Ophthalmology (Mar 2024)
Long-Term Satisfaction of Oral Sedation versus Standard-of-Care Intravenous Sedation for Ocular Surgery
Abstract
Minali Prasad,1,* Deniz Goodman,1,* Jia Xu,2 Sanhit Gutta,2 Daniella Zubieta,2 Sreevardhan Alluri,2 Nicole H Siegel,1,2 Crandall E Peeler,1,2 Hyunjoo J Lee,1,2 Howard J Cabral,3 Manju L Subramanian1,2 1Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; 2Department of Ophthalmology, Boston Medical Center, Boston, MA, USA; 3Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA*These authors contributed equally to this workCorrespondence: Manju L Subramanian, Department of Ophthalmology, Boston Medical Center, 85 East Concord Street, #8813, Boston, MA, 02118, USA, Tel +1 (617) 638 – 4555, Fax +1 (617) 414 – 2929, Email [email protected]: Long-term patient satisfaction may influence patients’ perspectives of the quality of care and their relationship with their providers. This is a follow up to a comparative effectiveness study investigating oral to intravenous sedation (OIV study). The OIV study found that oral sedation was noninferior in patient satisfaction to standard intravenous (IV) sedation for anterior segment and vitreoretinal surgeries. This study aims to determine if patient satisfaction with oral sedation remained noninferior long term.Patients and Methods: Patients were re-interviewed using the same satisfaction survey given during the OIV study. Statistical analysis involved t-tests for noninferiority of the long-term mean satisfaction score of oral and IV sedation. We also compared the original mean satisfaction score and the follow-up mean satisfaction score for each type of sedation and for both groups combined.Results: Participants were interviewed at a median of 1225.5 days (range 754– 1675 days) from their surgery. The original mean satisfaction score was 5.26 ± 0.79 for the oral treatment group (n = 52) and 5.27 ± 0.64 for the intravenous treatment group (n = 46), demonstrating noninferiority with a difference in mean satisfaction score of 0.015 (p < 0.0001). The follow-up mean satisfaction score was 5.23 ± 0.90 for oral sedation and 5.60 ± 0.61 for IV sedation, with a difference in the mean satisfaction score of 0.371 (p = 0.2071). Satisfaction scores did not differ between the original mean satisfaction score and the follow-up mean satisfaction score for the oral treatment group alone (p = 0.8367), but scores in the intravenous treatment group increased longitudinally (p = 0.0004).Conclusion: In this study, long-term patient satisfaction with oral sedation was not noninferior to satisfaction with IV sedation, unlike our findings with short-term patient satisfaction in our original study. Patient satisfaction also remained unchanged over time for the oral treatment group, but patients in the intravenous treatment group reported higher long-term satisfaction with their anesthesia experience compared to the immediate post-operative period.Keywords: longitudinal, ocular surgery, anesthesia, oral triazolam, intravenous midazolam, noninferiority
