Data from: Patients’ subjective assessment of the duration of cataract surgery: a case series

Objectives: Surgery duration is a source of preoperative anxiety for patients undergoing cataract surgery. To better inform patients, we evaluated the agreement between objective and patient-perceived surgery durations. Design: Case series. Setting: Public teaching university hospital (Paris, France). Participants: During the study period, 368 cataract surgery cases performed on 285 patients were included, 85 cases were excluded from the final analysis. All patients who had uneventful phacoemulsification were included. Cases with any significant intraoperative adverse event or cases requiring additional anaesthesia other than topical were excluded. Resident performed cases were also excluded. Primary and secondary outcomes: Procedures were timed (objective duration) and patients were asked, immediately afterwards, to assess the duration of their surgery (patient-assessed duration). The agreement between objective and patient-assessed durations as well as influencing factors was studied. Results: Mean objective duration (13.9±5 min) and patient-assessed duration (15.3±6.9 min) were significantly correlated (Spearman's r=0.452, p<0.0001). Furthermore, Bland-Altman analysis and the intraclass correlation coefficient (0.341, 95% CI 0.23 to 0.44) were quite in agreement. On univariate analysis, senior-performed procedures were significantly shorter than those performed by juniors (13.4 vs 17.8 min, p=0.0001). Pain was recorded as ‘no sensation’ (31.5% of the cases), ‘mild sensation’ (41%), ‘moderate pain’ (23.3%), ‘intense pain’ (3.5%) and ‘unbearable pain’ (0.7%). Groups with high pain score had significantly longer procedures (p<0.001). Multivariate analysis revealed that the only independent factors associated with both the objective and patient-assessed durations of surgery were surgeon's experience and pain-score. Conclusions: In our study, patients’ estimated and real duration of the surgery showed moderate agreement, suggesting that emotions associated with eye surgery under topical anaesthesia did not dramatically hinder the patients’ perception of time. However, the benefit of preoperative counselling regarding the duration of surgery will need further evaluation.

研究目的：手术时长是接受白内障手术患者术前焦虑的诱发因素之一。为更好地向患者做好术前告知工作，本研究评估了客观手术时长与患者主观感知的手术时长之间的一致性。
研究设计：病例系列研究。
研究地点：法国巴黎的公立教学大学医院。
研究对象：本研究期间共纳入285名患者的368例白内障手术病例，最终分析排除85例。纳入所有顺利完成超声乳化白内障吸除术（phacoemulsification）的患者，排除术中出现任何严重术中不良事件、需要接受表面麻醉以外的额外麻醉的病例，以及由住院医师主刀的手术病例。
主要与次要结局指标：记录手术的客观时长，并于术后即刻请患者评估自身手术的时长，分析客观手术时长与患者评估的手术时长之间的一致性及其影响因素。
研究结果：客观手术时长的平均值为13.9±5分钟，患者评估的手术时长平均值为15.3±6.9分钟，二者存在显著相关性（斯皮尔曼相关系数（Spearman's r）=0.452，p<0.0001）。此外，Bland-Altman分析结果及组内相关系数（intraclass correlation coefficient）为0.341（95%置信区间CI：0.23~0.44）均显示二者具有较好的一致性。单因素分析显示，高年资医师主刀的手术时长显著短于低年资医师（13.4分钟 vs 17.8分钟，p=0.0001）。疼痛评分情况为：无不适感（31.5%）、轻度不适（41%）、中度疼痛（23.3%）、剧烈疼痛（3.5%）以及难以忍受的疼痛（0.7%）。疼痛评分较高的组手术时长显著更长（p<0.001）。多因素分析显示，仅术者经验与疼痛评分这两个独立因素与手术客观时长及患者评估的手术时长均显著相关。
研究结论：本研究中，患者估算的手术时长与实际手术时长仅呈中度一致性，提示表面麻醉下眼科手术相关的情绪并未显著干扰患者对时间的感知。不过，术前针对手术时长的咨询的临床获益仍需进一步评估。