do I need sedatives?

[Chuckles960]

I posted a question about having my cataract operation just before going out of town. I decided that this was foolish. After I get back, the best available date is one where I have an important meeting later that day. But I am not sure I won't be in an altered state (so to speak).

What is the role of the sedatives? Simply to have a less nervous patient? I am not a hero, but as long as I'm getting anesthetics, I think I could do ok without needing to be shot with tranquilizer darts. My doctor says she will do it if I want. Am I crazy to want this? Will I run screaming from the operating table halfway through and thus mess up the operation and be blind for ever?

Have you done cataract surgery with anesthetic but without sedatives?

Many thanks!

[John C Hagan III, MD, FACS]

It would be a huge mistake in my opinion for you to go to an important meeting the afternoon of the same day you have IOL surgery. Decide which is the most important and only do one.

Our surgicenter will do about 30 cataract operations tomorrow. Most will be done without any sedation. Most will be done with topical anesthesia (no injections). One or two or three of the patients will need injection anesthesia (peribulbar anesthesia) for a variety of reasons: not able to hear, not able to cooperate, very very low pain tolerance, "sqeezers".  

During the procedure if they complain of pain or discomfort the anesthetist may give them some IV pain medication, if they are extraordinarily tense then they may get some IV sedation/anti anxiety mediation.

From the time the operation begins until it ends in most cases is less than 15 minutes. We have never had a patient get up off the table and run screaming out of the room.

You should do fine but don't do the surgery and the meeting.

JCH III MD

[Chuckles960]

Thanks for the reply! Never having had such an operation, my followup question is, why exactly is it a huge mistake? If I am not sedated and not in pain, what would make me nonfunctional?

I probably won't do it, given what you said, but I am curious to know in advance how I would feel different from normal. That way I'll know whether everything is as expected.

It's not a critical meeting, though. Something I should turn up for and not drool during, but it's not as though I'll be making a presentation to the CEO.

Thanks again!

[JodieJ]

If you skipped the sedation you probably could go to the meeting, although you might be feeling a little queasy (after all, you've just had an invasive procedure.)   I opted to go to the movies that afternoon.  (My surgeon thought this was fine.)  Cataract surgery with topical anesthesia is not painful, although you will experience some pressure.  At my surgical center, most of the cataract surgery patients received "light" IV sedation and topical anesthesia.  I was very grateful that my surgeon let me skip the IV Versed (which is supposed to be similar to Valium).

[John C Hagan III, MD, FACS]

You can never know how you'll be after surgery. You may need sedation, you may need IV pain medicine, you may be in discomfort, if you don't have to wear a patch you may be seeing double, you may have trouble with reading or your balance as your eyes start to relearn how to get along.

If you have to go anyplace go to the movies and let someone else drive.

JCH III MD