Background: Phacoemulsification is the most common surgical procedure performed in the United
States and European Union and sedation is commonly used during phacoemulsification to help
alleviate patient anxiety and prevent the patient from interfering with the procedure. The
investigators have administered ketamine in addition to midazolam in this regard. To study
the effectiveness of this technique, The investigators proposed a study to determine if
adding low-dose ketamine to midazolam has any beneficial (or negative) effects on operating
conditions, patient satisfaction, and recovery during and after unilateral
phacoemulsification procedures performed using topical anesthesia and intravenous (IV)
conscious sedation.
Methods: In a free-standing Outpatient Surgery Center, the investigators conducted a
randomized, double-masked, 3-arm, prospective comparison of IV midazolam only vs. midazolam
with ketamine 5 mg IV vs. midazolam with ketamine 10 mg IV. The investigators then measured a
single surgeon's assessment of surgical conditions, self-reported patient satisfaction,
postoperative pain score, and duration of postoperative stay. The investigators also analyzed
the dose of midazolam required to meet subjective anxiolysis in each group.