Comparing the Effect of Remifentanil, Propofol and Remifentanil Plus Propofol on the Sedation Score among Patients under Phacoemulsification Cataract Surgery

Document Type : Original Article (s)

Authors

1 Associate Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Resident, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study was aimed to determine the effects of remifentanil, propofol and remifentanyle plus propofol on the sedation score among patients under phacoemulsification cataract surgery with local anesthesia and comparison with a control group. Methods: In a clinical trial study in 2015-2016, 140 candidates for cataract surgery with phacoemulsification method randomly divided in four groups of 35 patients. Propofol, remifentanil, propofol plus remifentanil and normal saline was injected during surgery in the groups and sedation score was measured during surgery and compared between the four groups.Findings: Sedation score in the before operation in Propofol, remifentanil, propofol plus remifentanil and normal saline was 3.31 ± 0.87, 4.91 ± 0.28, 2.97 ± 0.75 and 4.97 ± 0.30, respectively (P < 0.001). Also sedation score at 30th min was 2.00 ± 0.01, 3.40 ± 0.55, 2.10 ± 1.00 and 3.00 ± 0.01, respectively (P = 0.110). The mean changes of the sedation score in the four groups were different (P < 0.001).Conclusion: Using remifentanil plus propofol in patients under phacoemulsification cataract surgery led to better sedation during surgery and lower post-operative pain. So, using both the drugs is recommended.

Keywords


  1. Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL. Miller's anesthesia. 7th ed. Philadelphia, PA: Churchill Livingstone; 2009. p. 2437.
  2. Katz J, Feldman MA, Bass EB, Lubomski LH, Tielsch JM, Petty BG, et al. Adverse intraoperative medical events and their association with anesthesia management strategies in cataract surgery. Ophthalmology 2001; 108(10): 1721-6.
  3. Habib NE, Mandour NM, Balmer HG. Effect of midazolam on anxiety level and pain perception in cataract surgery with topical anesthesia. J Cataract Refract Surg 2004; 30(2): 437-43.
  4. Aydin ON, Kir E, Ozkan SB, Gursoy F. Patient-controlled analgesia and sedation with fentanyl in phacoemulsification under topical anesthesia. J Cataract Refract Surg 2002; 28(11): 1968-72.
  5. Sivaci RG, Ermis S, Ozturk F. Fentanyl reduces cortisol and blood glucose changes during cataract surgery under retrobulbar anaesthesia. Eur J Anaesthesiol 2005; 22(4): 314-6.
  6. Fazel MR, Forghani Z, Razavizadeh SMR, Zabihi S, Vahedi MS, Adib H. Remifentanil versus propofol on pain and hemodynamic in patients under phacoemulsification with topical anesthesia. Sci J Kurdistan Univ Med Sci 2009; 13(4): 9-15. [In Persian].
  7. Alimian M, Imani F, Alebouyeh M, Zaman B, Siandoust A, Tarjoman Porshokouh R. comparison of sedative effect of remifentanil with propofol in senile cataract surgery under retro bulbar block. J Anesth Pain 2012; 2(7): 81-7.
  8. Boezaart AP, Berry RA, Nell ML, van Dyk AL. A comparison of propofol and remifentanil for sedation and limitation of movement during periretrobulbar block. J Clin Anesth 2001; 13(6): 422-6.
  9. Rewari V, Madan R, Kaul HL, Kumar L. Remifentanil and propofol sedation for retrobulbar nerve block. Anaesth Intensive Care 2002; 30(4): 433-7.