Table 1.

Clinical profile of patients receiving dexmedetomidine sedation under topical anesthesia

Patient number: reason for dex sedation under TA	Age	M/F	Operation	Duration of surgery (min)	Pain score	Surgeon comforta	HR in OR	BP in OR	O2 sat with intranasal O2 in OR	Duration of stay in RR before discharge (min)	HR in RR	BP in RR	O2 sat In RR under room air	Pain score in RR	RSS score in OR and RR	Outcome and use of other sedatives
N1: Patient refused GA; very deep-set eyeball; tight orbit	54	M	SB for RD	90	2	3	65	110/60	98	90	67	110/80	98	0/10 (Initial 4/10 relieved by iv perfalgan)	2	Flat retina; fentanyl 25 mcg and midazolam 0.5 mg were given 1 hour after surgery to prevent pain
N2: Patient ate a meal just before scheduled GA; very tight orbit	51	F	SB for RD	120	2	2	80	130/65	100	120	76	120/70	98	2/10	2	Flat retina; fentanyl 50 mcg given initially but was insufficient and, 15 min later, dex was started
N3: During PPV, dialysis was noted and treated with cryo	26	M	PPV with internal limiting membrane peel, endolaser, and cryo for RD from retinal dialysis	120	2	2	80	120/60	100	30	70	115/75	97	0/10	2	Flat retina; fentanyl 50 mg given at start of cryo, 15 min before end of procedure
N4: RD was detected intraoperatively	64	M	Cryo after PPV for vitreous hemorrhage. Peripheral flat RD detected intraoperatively	45	0	3	60	140/75	98	30	70	145/75	97	0/10	2	Flat retina
N5: Very deep-set eyeball; tight orbit; RBA would jeopardize already poor retinal circulation and increase further intraocular pressure	60	F	Cryo to retina and ciliary body for neovascular glaucoma with severe proliferative diabetic retinopathy and miotic pupil	30	0	3	90	140/90	100	90	78	130/80	100	0	2	Intraocular pressure dropped from 55 mmHg to 18 mmHg
N6: The eye needed very high laser energy setting because of albinotic fundus	55	M	PPV for RD repair from giant retinal tear	90	0	3	90	115/70	100	15	76	110/60	100	0/10	2	Flat retina; dex was used after fentanyl 50 mcg failed to control the pain
N7: Patient had open globe and ate just before surgery	40	M	Suturing of scleral laceration with uveal prolapse	30	2	1 Severe Bell’s phenomenon, continuous ocular and bodily movements	70	150/75	100	45	78	120/70	100	0	2	Stable
N8: Patient refused RBA	17	M	Cryo for exudative RD from Coats’ disease	15	0	3	80	160/80	99	60	100	120/70	99	0	2	Flat retina
N9: Patient refused RBA because of anticoagulant therapy	40	M	Cryo of ciliary body for traumatic glaucoma following traumatic RD repair	45	0	3	70	120/85	100	60	82	115/60	99	0/10	2	Recurrent glaucoma 4 months postoperatively; fentanyl 50 mcg failed to control pain, and, 15 min later, dex was started
Total/mean	47	7M/2F	SB, 2; cryo, 8; sclera laceration, 1	77	1.3	2.4 (good)	72.1	126/70	99.4	55.7	74	119/70	98.4	0/10	2	Two had other sedative prior to dex sedation; three needed sedatives during dex sedation; and two did not need additional sedatives

Note:

^aThe surgeon assessed surgical comfort at the end of surgery by rating the ease of performing the operation as excellent (3), good (2), fair (1), or poor (0).

Abbreviations: BP, blood pressure; cryo, cryopexy; dex, dexmedetomidine; F, female; GA, general anesthesia; HR, heart rate; M, male; min, minutes; O2 sat, oxygen saturation; OR, operating room; PPV, pars plana vitrectomy; RBA, retrobulbar anesthesia; RD, retinal detachment; RR, recovery room; SB, scleral buckle; TA, topical anesthesia.