Intravenous vs nonintravenous sedation for cataract surgery: systematic review and meta-analysis
Bibliographic record
Abstract
TOPIC: This review assesses the effectiveness of intravenous (IV) sedation compared with non-IV sedation for routine cataract surgery. CLINICAL RELEVANCE: Cataract surgery is a safe and routinely performed surgery. Sedation practices vary, with centers providing IV, oral, or no sedation for surgery. Improving sedation practices may have significant implications for patient safety, patient experience, and health system efficiency. METHODS: MEDLINE, Embase, Cochrane Library, BIOSIS, Web of Science, and CINAHL were searched from inception to July 2024 for relevant articles containing original data. Randomized controlled trials that compared IV with oral or no sedation and (1) used a validated pain scale to report on pain or (2) reported on perioperative complications were included. A random-effects meta-analysis was conducted. Odds ratios (ORs), standard mean differences (SMDs), 95% CIs, and I2 statistics were reported. The review was registered in PROSPERO (CRD42024582495), and PRISMA guidelines were followed. RESULTS: 12 randomized controlled trials including 1130 patients were included in the meta-analysis. IV sedation was associated with significantly decreased pain compared with no sedation (SMD, -0.98; 95% CI, -1.68 to -0.29). Comparing IV and oral sedation, however, there was no difference in patient-reported pain (SMD, -0.54; 95% CI, -1.60 to 0.52). Analysis of intraoperative complications showed that there was no significant difference in complications between patients receiving IV and oral sedation (OR, 0.68; 95% CI, 0.27-1.73). CONCLUSIONS: For routine cataract surgery, IV sedation was associated with less pain than no sedation, but oral and IV sedation provided comparable pain control. Perioperative complications occur at similar rates regardless of sedation modality. These findings may help to inform sedation practices for cataract surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.025 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.034 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".