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Randomized Controlled Trial
. 2025 Jun;263(6):1565-1572.
doi: 10.1007/s00417-025-06781-1. Epub 2025 Mar 18.

Factors associated with satisfaction with oral sedation during ophthalmic surgeries

Konstantina Sampani #  1   2 , Ahsan Hussain #  3   4 , Nayan Sanjiv  3   4 , Samaneh Davoudi  3   4 , Sreevardhan Alluri  3 , Hyunjoo J Lee  3   4 , Steven Ness  3   4 , Susannah Rowe  3   4 , Manju L Subramanian  5   6 ; Oral versus Intravenous Sedation Study Group
Collaborators, Affiliations
Randomized Controlled Trial

Factors associated with satisfaction with oral sedation during ophthalmic surgeries

Konstantina Sampani et al. Graefes Arch Clin Exp Ophthalmol. 2025 Jun.

Abstract

Purpose: To investigate patient and surgical characteristics associated with higher patient, surgeon, or anesthesia provider satisfaction with oral sedation in ophthalmic procedures.

Design: This was a secondary analysis of a prospective, randomized, double-masked, non-inferiority clinical trial measuring patient satisfaction comparing oral versus intravenous (IV) sedation for ophthalmic surgeries.

Methods: Data was collected from a validated 6-point satisfaction survey from patients, surgeons, and anesthesia providers. We focused on the oral sedation arm and used multivariate regression analysis to investigate the relationship between satisfaction scores and patients' characteristics, surgery duration, and need for additional anesthesia during the ophthalmic procedure.

Results: In total, 142 patients receiving initial oral triazolam with IV placebo were included in this study. Non-White (p = 0.02) and non-English speaker patients (p = 0.003) had higher satisfaction scores with oral sedation. Shorter surgery duration was associated with higher satisfaction scores for both patients (p = 0.01) and surgeons (p = 0.03) but not for anesthesia providers (p = 0.21). The need for supplemental IV sedation intraoperatively was significantly associated with lower satisfaction scores among patients (p < 0.001), surgeons (p < 0.001), and anesthesia providers (p < 0.001).

Conclusions: Shorter length of surgery was positively associated with higher patient and surgeon satisfaction with oral sedation. Other factors including non-White race and non-English primary language were associated with higher patient satisfaction. Additional IV sedation needed during surgery was associated with worse patient, surgeon, and anesthesia provider satisfaction. Tailoring oral sedation to procedures that are shorter in duration may help maximize the success of oral sedation as an alternative to intravenous sedation.

Keywords: Ocular procedures; Oral conscious sedation; Patient satisfaction; Quality measures.

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Conflict of interest statement

Declarations. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the Boston Medical Center’s Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The original study was a prospective, single-center, randomized, double-masked, parallel-group, noninferiority clinical trial ( www.clinicaltrials.gov identifier NCT03246724) conducted at an urban teaching hospital (Boston Medical Center, Boston, Massachusetts). Informed consent: Informed consent was obtained from all individual participants included in the study. Conflicts of interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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