Conscious Monitored Anesthesia Care versus General Anesthesia for Vitreoretinal Surgeries

Ehsan Namvar,1 Alireza Attar,1 Mehrdad Salari,2 Mohammad Alamdari,1 Maryam Hadipour3 1Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; 2Anesthesiology and Critical Care Research Center, Department of Anesthesiology and Critical Care, School of Medicine, Shiraz University of Medical Science, Shiraz, Iran; 3Health Policy Research Center, Institute of Health, School of Medicine, Shiraz University of Medical Science, Shiraz, IranCorrespondence: Mehrdad Salari, Anesthesiology and Critical Care Research Center, Department of Anesthesiology and Critical Care, School of Medicine, Shiraz University of Medical Science, Shiraz, Iran, Email [email protected]: This study compares monitored anesthesia care (MAC) with general anesthesia (GA) for vitreoretinal surgery, aiming to assess safety, efficacy, and patient outcomes.Patients and Methods: This was a prospective non-randomized clinical trial. This trial was conducted during vitreoretinal surgery. Forty Patients were included in this study and divided into MAC and GA groups. The patients were divided in to two groups. In one group, patients who were operated under general anesthesia and in the other group those who were operated with conscious sedation were included. Anesthesia quality, surgical outcomes, anesthesia time, surgery time and recovery time were compared between two groups using standardized criteria and statistical analysis.Results: MAC provided comparable analgesia, immobilization, and hemodynamic stability to GA, with no reported complications. All patients in both groups had successful surgery. Anesthesiologist favored MAC for its hemodynamic control, while surgeons showed no preference. MAC exhibited shorter anesthesia time than GA with lower anesthetics. These findings support the use of MAC in vitreoretinal surgery, especially for patients at risk of complications from GA.Conclusion: Moderate sedation with MAC offers a safe and effective alternative to GA for vitreoretinal surgery, with similar outcomes, reduced anesthesia time, and lower drug doses. Further research with larger cohorts is warranted to validate these results and refine anesthesia protocols.Keywords: moderate sedation, conscious sedation, monitored anesthesia care, general anesthesia, vitreoretinal surgeries