Probing for nasolacrimal duct obstruction with intravenous propofol sedation

Background: Nasolacrimal duct obstruction occurs in 5% to 6% of neonates. M any studies advocate the probing of nasolacrimal duct obstruction under gen eral inhalational anesthesia in patients at a late age (12 to 13 months) be cause a high percentage will resolve spontaneously. Others support early su rgical intervention in patients aged younger than 6 to 9 months without ane sthesia. We present late nasolacrimal duct probing under intravenous propof ol sedation as an alternative approach to the treatment of nasolacrimal duc t obstruction with a decrease in cost and time compared with probing under general inhalational anesthesia. Methods: We made a retrospective review of patient charts of children who underwent nasolacrimal duct probing with in travenous propofol sedation from April 1996 to September 1997. Procedure ti me and cost of procedure were compared for patients who had probings under propofol sedation to patients who had probings under general anesthesia. Re sults: A total of 22 patients (31 eyes) underwent nasolacrimal duct probing with propofol sedation; the patients' ages ranged from 11.5 to 39 months ( average age, 17.8 months). Twenty-six (84%) of 31 eyes had resolution of th e symptoms. The average total time for procedure under propofol sedation wa s 10.5 minutes, compared with 43.6 minutes under general inhalational anest hesia. The average total recovery time under propofol sedation was 13.6 min utes, compared with 121.1 minutes with general inhalational anesthesia. The cost of probing under propofol sedation was one third less than the cost o f probing under general inhalational anesthesia. Discussion: Late probing f or nasolacrimal duct obstruction under intravenous propofol sedation is com parable in efficacy to late probing under general inhalational anesthesia w ith a shorter time for the procedure and decreased expense.