Psychological effects of sedation in oculoplastic surgery: State anxiety, visuo-motor functioning, pain and post-surgical subjective amnesia

The use of short acting sedation in association with local anaesthesia is increasing in surgical care. The present study evaluated the psychological effects of sedation in oculoplastic surgery by using a RCT comparison between a short acting sedation infusion (Midazolam) and a standard procedure using a saline placebo infusion. The sedation group showed a significantly reduced post-operative state anxiety level not shown in patients undergoing the standard procedure. The sedation group showed a trend to better performance on the WAIS digit symbol substitution test (DSST) as a post-operative visual motor task. Inter-relationships between state anxiety, visuo-motor functioning, age and duration of operation showed different patterns in the two groups. Patients in the sedation group reported greater amnesia for the operative period but retrospective ratings of pain were not significantly different between groups. Consumer ratings of understanding and satisfaction with information were predominantly high. The need for psychological models to explain such differential outcome effects of sedation is explored.