Efficacy of Pre-Operative Salbutamol Nebulization in Improving Patient Comfort and Surgical Outcomes during Cataract Surgery in COPD and Asthma Patients

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Background: Patients with bronchial asthma and chronic obstructive pulmonary disease (COPD) are at increased risk of perioperative respiratory discomfort even during minor procedures such as cataract surgery performed under local anesthesia. Intraoperative coughing, dyspnea, and poor cooperation may adversely affect surgical outcomes. Preoperative bronchodilation with salbutamol may improve respiratory stability and patient comfort; however, evidence in ophthalmic surgeries is limited. Aim: To compare the efficacy of preoperative salbutamol nebulization in improving patient comfort and surgical outcomes during cataract surgery in patients with COPD and/or asthma, and to propose a standard preoperative protocol. Methods: A hospital-based cross-sectional comparative study was conducted over one year in a tertiary care center. Thirty adult patients with bronchial asthma and/or COPD undergoing cataract surgery were randomly allocated into two groups: salbutamol group (n=15), receiving preoperative nebulization with salbutamol (2.5 mg), and control group (n=15), receiving standard care without nebulization. Patient comfort (better/uneventful vs breathlessness) and intraoperative surgical conditions (uneventful vs disrupted) were assessed. Statistical analysis was performed using Chi-square test, with p<0.05 considered significant. Results: The mean age was comparable between the salbutamol (65.4 ± 7.3 years) and control groups (69.9 ± 7.8 years). Good patient comfort was observed in 86.7% of patients in the salbutamol group compared to 40.0% in the control group (χ²=7.03, p=0.008). Breathlessness was significantly lower in the intervention group (13.3% vs 60.0%). Uneventful surgical conditions were achieved in 86.7% of patients receiving salbutamol compared to 40.0% in controls (χ²=7.03, p=0.008). Conclusion: Preoperative salbutamol nebulization significantly improves intraoperative patient comfort and surgical conditions in patients with COPD and asthma undergoing cataract surgery. Incorporating this simple and cost-effective intervention into routine preoperative protocols may enhance surgical outcomes and patient experience.

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