Evidence Report/Technology Assessment Number 16

Anesthesia Management During Cataract Surgery
Volume 1: Evidence Report
Volume 2: Evidence Tables and Bibliography

File Inventory


Prepared by:

Johns Hopkins University Evidence-based Practice Center
Oliver D. Schein, M.D., M.P.H.
   Principal Investigator
David S. Friedman, M.D., M.P.H.
Lee A. Fleisher, M.D.
   Co-Principal Investigators
Lisa H. Lubomski, Ph.D.
Jeffrey Magaziner, M.D.
Michael Sprintz, M.D.
John Kempen, M.D., M.P.H.
Sherman W. Reeves
Karen A. Robinson, M.Sc.
Eric B. Bass, M.D., M.P.H.
   Investigators


File Name	Description			Software		Version		File	Size
__________________________________________________________________________________________________________
01front.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	35KB	10 pages
Contents: Volume 1 Title Page, Preface, Structured Abstract, Table of Contents
__________________________________________________________________________________________________________
02summ.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	21KB	4 pages
Contents: Summary: Overview, Reporting the Evidence, Methodology, Findings, Future Research
__________________________________________________________________________________________________________
03chap1.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	3 pages
Contents: Chapter 1. Introduction: Background, Purpose of Evidence Report
__________________________________________________________________________________________________________
04chap2.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	41KB	9 pages
Contents: Chapter 2. Methodology: Recruitment of Experts, Patient Population, 
Identifying the Specific Questions, Causal Pathway, Literature Search Methods, Article Review,
Summary Evidence Tables, Synthesis Tables, Grading the Evidence, Meta-analysis, 
Supplemental Analyses, Peer Review
__________________________________________________________________________________________________________
05chap3.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	150KB	24 pages
Contents: Chapter 3. Results: Results of the Literature Search and Abstract Review, 
Results of the Studies, Assessment of the Strength of the Evidence
__________________________________________________________________________________________________________
06chap4.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	21KB	4 pages
Contents: Chapter 4. Conclusions: Conclusions Regarding Local Anesthesia Techniques, 
Conclusions Regarding Sedation Strategies
__________________________________________________________________________________________________________
07chap5.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	1 page
Contents: Chapter 5. Future Research
__________________________________________________________________________________________________________
08refs.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	52KB	9 pages
Contents: References
__________________________________________________________________________________________________________
09suppl.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	48KB	8 pages
Contents: Supplemental Analyses
__________________________________________________________________________________________________________
10appa.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	6KB	1 pages
Contents: Appendix A. Peer Reviewers
__________________________________________________________________________________________________________
11appb.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	19KB	6 pages
Contents: Appendix B. Question Refinement Mailing
__________________________________________________________________________________________________________
12appc.ppt	MS PowerPoint® Presentation	MS PowerPoint®		2000		25KB	1 page
Contents: Appendix C. Causal Pathway of Anesthesia Management for Cataract Surgery
__________________________________________________________________________________________________________
13appd.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	14KB	4 pages
Contents: Appendix D. Search Strategies
__________________________________________________________________________________________________________
14appe.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	1 page
Contents: Appendix E. List of Hand-Searched Journals
__________________________________________________________________________________________________________
15appf.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	14KB	1 page
Contents: Appendix F. Abstract Review Form
__________________________________________________________________________________________________________
16appg.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	37KB	7 pages
Contents: Appendix G. Article Quality Assessment Form
__________________________________________________________________________________________________________
17apph.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	395KB	54 pages
Contents: Appendix H. Article Content Abstraction Form
__________________________________________________________________________________________________________
18appi.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	25KB	2 pages
Contents: Appendix I.  Questions for Literature Synthesis
__________________________________________________________________________________________________________
19appj.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	17KB	2 pages
Contents: Appendix J. Peer Review Response Form for Draft Report
__________________________________________________________________________________________________________
20appk.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	15KB	1 page
Contents: Appendix K. Summary of Searches
__________________________________________________________________________________________________________
21appl.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	15KB	2 pages
Contents: Appendix L. Abstract Review Summary
__________________________________________________________________________________________________________
22appm.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	21KB	4 pages
Contents: Appendix M. Articles Excluded During Full Article Abstraction
__________________________________________________________________________________________________________
23appn.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	12KB	1 page
Contents: Appendix N. Reasons for Article Exclusion
__________________________________________________________________________________________________________
24appo.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	12KB	1 page
Contents: Appendix O. Summary of Quality Review
__________________________________________________________________________________________________________
25appp.ppt	MS PowerPoint® Presentation	MS PowerPoint®		2000		45KB	1 page
Contents: Appendix P. Decision Tree
__________________________________________________________________________________________________________
26appq.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	28KB	5 pages
Contents: Appendix Q. Decision Analysis Tables
__________________________________________________________________________________________________________
27appr.ppt	MS PowerPoint® Presentation	MS PowerPoint®		2000		29KB	1 page
Contents: Appendix R. Average Expected Cost Versus Average Expected Preference Value 
for Six Anesthesia Scenarios
__________________________________________________________________________________________________________
28apps.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	11KB	1 page
Contents: Appendix S. Medicare Claims Analysis Tables
__________________________________________________________________________________________________________
29frntv2.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	31KB	5 pages
Contents: Volume 2 Title Page, Table of Contents
__________________________________________________________________________________________________________
30etacro.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	7KB	2 pages
Contents: Acronyms and Abbreviations Used in the Evidence Tables
__________________________________________________________________________________________________________
31etbl1.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	179KB	70 pages
Contents: Evidence Table 1. Overall summary of literature on anesthesia for cataract surgery
__________________________________________________________________________________________________________
32etbl2.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	335KB	95 pages
Contents: Evidence Table 2. Summary of interventions reported in literature on anesthesia 
for cataract surgery
__________________________________________________________________________________________________________
33etbl3.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	103KB	23 pages
Contents: Evidence Table 3. Methodologic quality of literature on anesthesia for cataract surgery
__________________________________________________________________________________________________________
34etbl4.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	16KB	2 pages
Contents: Evidence Table 4. Local anesthesia: Is there evidence that a retrobulbar block 
is more effective at producing akinesia than a peribulbar block?
__________________________________________________________________________________________________________
35etbl5.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	1 page
Contents: Evidence Table 5. Local anesthesia: Is there evidence that a retrobulbar block 
is more effective at producing akinesia than a subconjunctival/sub-Tenon's block?
__________________________________________________________________________________________________________
36etbl6.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	1 page
Contents: Evidence Table 6. Local anesthesia: Is there evidence that a peribulbar block 
is more effective at producing akinesia than a subconjunctival/sub-Tenon's block?
__________________________________________________________________________________________________________
37etbl7.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	44KB	9 pages
Contents: Evidence Table 7. Local anesthesia: Is there evidence of the effectiveness 
of a peribulbar block at producing akinesia?
__________________________________________________________________________________________________________
38etbl8.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	30KB	5 pages
Contents: Evidence Table 8. Local anesthesia: Is there evidence of the effectiveness 
of a retrobulbar block at producing akinesia?
__________________________________________________________________________________________________________
39etbl9.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	7KB	1 page
Contents: Evidence Table 9. Local anesthesia: Is there evidence of the effectiveness 
of a subconjunctival/sub-Tenon's block in producing akinesia?
__________________________________________________________________________________________________________
40etbl10.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	30KB	3 pages
Contents: Evidence Table 10. Local anesthesia: Is there evidence that adding hyaluronidase 
to local blocks produces better akinesia than not adding hyaluronidase?
__________________________________________________________________________________________________________
41etbl11.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	22KB	2 pages
Contents: Evidence Table 11. Local anesthesia: Is there evidence that certain anesthetic agents 
used in local blocks produce better akinesia?
__________________________________________________________________________________________________________
42etbl12.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	12KB	2 pages
Contents: Evidence Table 12. Local anesthesia: Is there evidence that the volume of anesthetic used 
and speed of injection affect the amount of akinesia obtained and pain during the block 
or surgery with local blocks?
__________________________________________________________________________________________________________
43etbl13.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	14KB	1 page
Contents: Evidence Table 13. Local anesthesia: Is there evidence that the retrobulbar 
block technique is more or less painful than the peribulbar block during administration of the block?
__________________________________________________________________________________________________________
44etbl14.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	13KB	1 page
Contents: Evidence Table 14. Local anesthesia: Is there evidence that retrobulbar block techniques 
are more painful for the patient while being administered than subconjunctival/sub-Tenon's block techniques?
__________________________________________________________________________________________________________
45etbl15.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	10KB	1 page
Contents: Evidence Table 15. Local anesthesia: Is there evidence that peribulbar block techniques 
are more painful for the patient while being administered than subconjunctival/sub-Tenon's block techniques?
__________________________________________________________________________________________________________
46etbl16.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	45KB	4 pages
Contents: Evidence Table 16. Local anesthesia: Summary of evidence regarding pain 
during administration of peribulbar block
__________________________________________________________________________________________________________
47etbl17.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	32KB	2 pages
Contents: Evidence Table 17. Local anesthesia: Summary of evidence regarding pain 
during administration of retrobulbar block
__________________________________________________________________________________________________________
48etbl18.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	7KB	1 page
Contents: Evidence Table 18. Local anesthesia: Summary of evidence regarding pain 
during administration of subconjunctival/sub-Tenon's block
__________________________________________________________________________________________________________
49etbl19.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	9KB	1 page
Contents: Evidence Table 19. Local anesthesia: Is there evidence that retrobulbar block 
is more or less painful for the patient during administration than topical block?
__________________________________________________________________________________________________________
50etbl20.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	12KB	1 page
Contents: Evidence Table 20. Local anesthesia: Is there evidence that peribulbar block 
is more or less painful for the patient while being administered than topical block?
__________________________________________________________________________________________________________
51etbl21.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	1 page
Contents: Evidence Table 21. Local anesthesia: Is there evidence that 
subconjunctival/sub-Tenon's block is more or less painful to the patient during administration 
than topical block?
__________________________________________________________________________________________________________
52etbl22.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	14KB	1 page
Contents: Evidence Table 22. Local anesthesia: Is there evidence that retrobulbar block techniques 
result in more or less pain during cataract surgery than peribulbar block techniques?
__________________________________________________________________________________________________________
53etbl23.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	12KB	1 page
Contents: Evidence Table 23. Local anesthesia: Is there evidence that retrobulbar block techniques 
result in more or less pain during cataract surgery than subconjunctival/sub-Tenon's techniques?
__________________________________________________________________________________________________________
54etbl24.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	7KB	1 page
Contents: Evidence Table 24. Local anesthesia: Is there evidence that peribulbar block techniques 
result in more or less pain during cataract surgery than subconjunctival/sub-Tenon's block techniques?
__________________________________________________________________________________________________________
55etbl25.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	47KB	6 pages
Contents: Evidence Table 25. Local anesthesia: Summary of the evidence regarding pain 
during cataract surgery after peribulbar block
__________________________________________________________________________________________________________
56etbl26.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	19KB	2 pages
Contents: Evidence Table 26. Local anesthesia: Summary of the evidence regarding pain 
during cataract surgery after retrobulbar block
__________________________________________________________________________________________________________
57etbl27.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	9KB	1 page
Contents: Evidence Table 27. Local anesthesia: Summary of the evidence regarding pain 
during cataract surgery after subconjunctival/sub-Tenon's injection
__________________________________________________________________________________________________________
58etbl28.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	14KB	1 page
Contents: Evidence Table 28. Local anesthesia: Is there evidence that retrobulbar block techniques 
result in more or less pain during cataract surgery than topical block?
__________________________________________________________________________________________________________
59etbl29.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	11KB	1 page
Contents: Evidence Table 29. Local anesthesia: Is there evidence that peribulbar block techniques 
result in more or less pain during cataract surgery than topical block techniques?
__________________________________________________________________________________________________________
60etbl30.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	10KB	1 page
Contents: Evidence Table 30. Local anesthesia: Is there evidence that 
subconjunctival/sub-Tenon's block techniques result in more or less pain 
during cataract surgery than topical block techniques?
__________________________________________________________________________________________________________
61etbl31.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	14KB	2 pages
Contents: Evidence Table 31. Local anesthesia: Is pain control improved by adding 
intracameral lidocaine to topical anesthesia?
__________________________________________________________________________________________________________
62etbl32.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	10KB	1 page
Contents: Evidence Table 32. Local anesthesia: Is there evidence that using hyaluronidase 
reduces the amount of pain experienced by the patient during cataract surgery?
__________________________________________________________________________________________________________
63etbl33.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	16KB	2 pages
Contents: Evidence Table 33. Local anesthesia: Is there evidence that certain anesthetic agents 
result in more or less pain during cataract surgery than other agents?
__________________________________________________________________________________________________________
64etbl34.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	1 page
Contents: Evidence Table 34. Local anesthesia: Is there evidence that warming of the 
anesthetic agents results in improved akinesia or pain control during the block and during the operation?
__________________________________________________________________________________________________________
65etbl35.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	10KB	1 page
Contents: Evidence Table 35. Local anesthesia: Is there evidence that pH adjustment 
yields more effective local blocks?
__________________________________________________________________________________________________________
66etbl36.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	79KB	17 pages
Contents: Evidence Table 36. Local anesthesia: Summary of the evidence regarding complications 
of retrobulbar blocks
__________________________________________________________________________________________________________
67etbl37.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	85KB	18 pages
Contents: Evidence Table 37. Local anesthesia: Summary of the evidence regarding complications 
of peribulbar blocks
__________________________________________________________________________________________________________
68etbl38.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	25KB	4 pages
Contents: Evidence Table 38. Local anesthesia: Summary of the evidence on complication rates 
with subconjunctival anesthesia
__________________________________________________________________________________________________________
69etbl39.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	24KB	4 pages
Contents: Evidence Table 39. Local anesthesia: Summary of the evidence on complication rates 
with topical anesthesia
__________________________________________________________________________________________________________
70etbl40.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	11KB	1 page
Contents: Evidence Table 40. Sedation: Is sedation associated with improved pain control/
patient cooperation compared to local anesthesia alone?
__________________________________________________________________________________________________________
71etbl41.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	1 page
Contents: Evidence Table 41. Sedation: Is sedation associated with improved anxiety control/
patient satisfaction compared to local anesthesia alone?
__________________________________________________________________________________________________________
72etbl42.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	8KB	1 page
Contents: Evidence Table 42. Sedation: Is sedation associated with improved hemodynamics outcomes 
compared to local anesthesia alone?
__________________________________________________________________________________________________________
73etbl43.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	19KB	3 pages
Contents: Evidence Table 43. Sedation: Summary of evidence on the effectiveness of oral and 
intramuscular sedation regarding patient cooperation and pain
__________________________________________________________________________________________________________
74etbl44.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	9KB	1 page
Contents: Evidence Table 44. Sedation: Summary of evidence on the effectiveness of oral and 
intramuscular sedation regarding anxiety and satisfaction
__________________________________________________________________________________________________________
75etbl45.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	16KB	4 pages
Contents: Evidence Table 45. Sedation: Summary of evidence on the effectiveness of oral or 
intramuscular sedation regarding medical and hemodynamic complications
__________________________________________________________________________________________________________
76etbl46.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	32KB	6 pages
Contents: Evidence Table 46. Sedation: Summary of evidence on the effectiveness of 
intravenous sedation regarding patient cooperation and pain
__________________________________________________________________________________________________________
77etbl47.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	18KB	2 pages
Contents: Evidence Table 47. Sedation: Summary of evidence on the effectiveness of 
intravenous sedation regarding patient anxiety and satisfaction
__________________________________________________________________________________________________________
78etbl48.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	16KB	4 pages
Contents: Evidence Table 48. Sedation: Summary of evidence on the effectiveness of 
intravenous sedation regarding medical outcomes and complications
__________________________________________________________________________________________________________
79etbl49.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	18KB	2 pages
Contents: Evidence Table 49. Sedation: Comparison of intravenous agents regarding 
patient cooperation and pain
__________________________________________________________________________________________________________
80etbl50.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	10KB	1 page
Contents: Evidence Table 50. Sedation: Comparison of intravenous agents regarding 
anxiety control and satisfaction
__________________________________________________________________________________________________________
81etbl51.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	13KB	3 pages
Contents: Evidence Table 51. Sedation: Comparison of intravenous agents regarding 
medical complications and hemodynamics
__________________________________________________________________________________________________________
82etbl52.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	7KB	1 page
Contents: Evidence Table 52. Sedation: Safety and effectiveness of patient-controlled anesthesia 
regarding pain and cooperation
__________________________________________________________________________________________________________
83etbl53.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	7KB	1 page
Contents: Evidence Table 53. Sedation: Safety and effectiveness of patient-controlled anesthesia 
regarding medical complications and hemodynamics
__________________________________________________________________________________________________________
84biblio.wpd	Corel WordPerfect® Document	Corel WordPerfect®	6/7/8/9/10	63KB	10 pages
Contents: Bibliography
__________________________________________________________________________________________________________

AHRQ Publication No. 01-E017
Current as of August 2001


Internet Citation:

Anesthesia Management During Cataract Surgery. File Inventory, Evidence Report/Technology Assessment Number 16. AHRQ Publication No. 01-E017, August 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/cataninv.htm


Return to Evidence-based Practice
Clinical Information
AHRQ Home Page
Department of Health and Human Services