Similar ratings during a procedure do not establish identical recovery or patient experience.
The randomized study compared fentanyl paired with etomidate, propofol or midazolam during cataract surgery. Ninety-eight of 150 enrolled patients completed the study. Ramsay sedation-score distributions did not differ significantly, while median recovery was longer with midazolam than propofol. Satisfaction also differed between some groups.
The limited completed sample and substantial difference between enrollment and completion warrant attention. These were combination regimens, and a nonsignificant sedation comparison does not establish equivalence. The study cannot isolate the fentanyl contribution or describe all uncommon complications.
For an expert review, separate the ability to complete the operation, sedation depth, recovery time and satisfaction. Check exclusions and timing definitions before applying group averages to one patient. An acceptable intraoperative score does not establish that later function has fully recovered.
Source reviewed: Comparison of the Sedation Quality of Etomidate Propofol and Midazolam in Combination with Fentanyl (PMC6616865). Forensic applications above are interpretive analysis of the supplied publication.
Related reading: Pediatric Sedation Z-Scores Were Relative Burden Measures Rather Than Dose Equivalents.