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On-line version ISSN 1806-907X
Rev. Bras. Anestesiol. vol.58 no.4 Campinas July/Aug. 2008
LETTERS TO THE EDITOR
Dear colleague, we would like to emphasize some aspects regarding your comments on our study. First, it is clear under methods that patients received boluses of alfentanil according to their needs (any type of discomfort and pain). We did not consider mild pain as discomfort; therefore, there is no euphemism. Pain is subjective, which is necessary for its understanding, and we cannot determine its severity but through the statement of the person who feels it. There are several situations in this type of intervention that cause discomfort, such as washing the eye with NS, manipulating the iris, etc. Table IV showed the percentage of alfentanil used in both cases, and not only in patients who complained of pain.
As for the efficacy of the technique, our conclusion is on the association of topical anesthesia and sedation, not on topical anesthesia alone, as stated in the text: "Topical anesthesia associated with sedation showed to be easy to administer, practical, fast, and accessible to any professional and health care facility involved in the treatment of cataracts, but patients should be carefully selected by an anesthesiologist and followed by this professional. Sedation was an important contribution, especially in patients who were anxious and uneasy, because it favored patient tranquility and, consequently, greater collaboration. Good patient acceptance and low rate of complications indicate that this technique can be diffused, made public, and used, respecting the learning curve and abilities of each surgeon."
Finally, we can affirm that our conclusions were correct and reflect a large cohort and a large daily practice, which can be interpreted in view of this scientific work.
João Batista Santos Garcia, TSA
Caio Márcio Barros de Oliveira, TSA
Adriana Leite Xavier Bertrand