1 Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China 2 Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China 3 Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China 4 Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Abstract:Objective: The factors affecting the comfort of patients undergoing cataract surgery were systematically evaluated in order to provide a reliable basis for improving surgical comfort. Methods: The following databases were searched: China National Knowledge Infrastructure (CNKI), the Wanfang Database, the Vip Database, PubMed, Embase and Cochrane Library. Two researchers extracted data and independently assessed the quality of the articles. Meta-analysis was performed using RevMan 5.3 software. Results: A total of 12 911 patients undergoing cataract surgery in 52 randomized controlled trials were included in this study. The factors affecting cataract surgery were classified and nursing methods, types of anesthetics and location where surgery was performed were also classified. Factors that could not be classified as above were divided into preoperative factors like oral sedation, intraoperative factors like auxiliary oxygen inhalation and postoperative factors such as postoperative eye pads and so on. Meta-analysis showed that compared with conventional nursing, collaborative nursing could improve the comfort of cataract patients with RR=1.21 (95%CI: 1.13, 1.30, P<0.001). There was no significant difference in anesthetic effect or comfort between lidocaine and other topical anesthetics, MD=-0.69 (95%CI: 1.51, 0.14, P<0.001). Compared to a balanced salt solution, an intravenous infusion of fentanyl could significantly reduce the frequency of pressing and administration of a patient-controlled analgesia device, which indicated that fentanyl could improve the comfort of patients, MD=-1.77 (95%CI: 2.19, -1.39, P<0.001). The anesthetic effect and patient comfort were better in the sub-Tenon's group than in the topical anesthesia group, MD=1.02 (95%CI: 1.33, 0.71, P<0.001). Due to a lack of research literature or statistical results, it was difficult to perform other factors in meta-analysis, however, a systematic review was done. Conclusions: There are many factors affecting the comfort of cataract patients undergoing surgery which can be gradually promoted and applied in the clinic to improve the comfort of cataract surgery and the quality of life of patients.
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