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Correspondence to:
Dr Wendy E Adams
Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland SR2 9HP, UK; wendy_stoer@yahoo.com
Accepted for publication 31 May 2005
Keywords: sub-Tenon’s block; topical anaesthesia
We read with great interest the results of the pilot study comparing patient 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 Iowa Satisfaction with Anesthesia Scale (ISAS), 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 anaesthesia gives better satisfaction than topical anaesthesia, purely based on this scale, is slightly premature.
The ISAS is due to be validated soon using local anaesthesia and sedation3; 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
Rüschen H , Celaschi D, Bunce C, et al. Randomised controlled trial of sub-Tenon’s block versus topical anaesthesia for cataract surgery: a comparison of patient satisfaction. Br J Ophthalmol 2005;89:291–3.
Dexter F , Aker J, Wright WA. Development of a measure of patient satisfaction with monitored anesthesia care: the Iowa Satisfaction with Anesthesia Scale. Anesthesiology 1997;87:865–73.
Fung D , Cohen M, Stewart S, et al. 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 Analgesia 2005;100(6).