Patient-controlled sedation using propofol in elderly patients in day-casecataract surgery

Patient-controlled sedation (PCS) with propofol has been used successfully as an adjunct to local anaesthetic procedures. We studied a group of elderl y patients (mean age 75.4 yr) undergoing cataract surgery and attempted to increase patient acceptability and comfort of local anaesthesia. Propofol w as self-administered in a dose of 0.25 mg kg(-1) for patients more than 60 yr of age, with a lockout period of 3 min. A total of 14 of 20 patients use d PCS; eight of 20 used the PCS only once and another six had three tries o r less. Despite this, 18 of 20 patients claimed they found the PCS useful. However, while it is possible to administer PCS successfully to elderly pat ients undergoing cataract surgery and produce a decrease in the level of an xiety, we found it unacceptable because of head movement in two patients. T hese patients received only two and three divided doses, to a maximum of 29 and 30 mg, respectively. There were no other adverse events.