Unanticipated hospital admissions for patients undergoing day surgery for cataract under monitored anesthesia care: a single center study

Choi, Eun Su; Jo, Yoon Ji; Shin, Jiyeon; Park, Hee Pyoung

Abstract

BACKGROUND
The incidence of unanticipated hospital admissions (UHA) for patients undergoing day surgery for cataract is not being reported in Korea. We investigate the incidence and causes of UHA, and the incidence of intraoperative adverse events for patients undergoing cataract surgery.
METHODS
Electric medical charts of patients who underwent cataract surgery under monitored anesthesia care (MAC) in day surgery units from Nov 2011 to Jul 2012 were being reviewed.
RESULTS
1,374 cataract surgeries were performed in 942 patients. UHA was shown in six (0.4%) patients, who underwent cataract surgery only under MAC. Posterior capsular ruptures (three cases) and intraocular lens dislocation (one case) involved surgery-related UHAs, while severe postoperative nausea and vomiting (one case) led to anesthesia-related UHAs. Acute cerebral infarction (one case) was one cause of UHA. The incidences of intraoperative hypotension (mean arterial pressure [MBP] < 80% of initial MBP) and hypertension (MBP > 120% of initial MBP) were 24.4% and 7.7% respectively. Of patients with hypertension, about 3% required treatments. Bradycardia (heart rate < 60 beats/min) and tachycardia (heart rate > 100 beats/min) were observed in 29.7% and 4.1% respectively. But, no cases required treatments. The incidences of oxygen desaturation (oxygen saturation with pulse oximetry < 90%) and respiratory depression (respiration rate < 10 frequencies/min) were 0.3% and 1.8% respectively.
CONCLUSIONS
The incidences of UHA and intraoperative adverse events were low for patients undergoing cataract surgery under MAC in our day surgery unit. A large-scaled multicenter study is necessary to find risk factors of UHA.