| The Effect of Remifentanil, Alfentanil, and Fentanyl on the Hemodynamic Changes, Analgesia, and Sedation during Retrobulbar Block in Cataract Surgery. |
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Sei Keun Im, Gill Hoi Koo, Hyun Kang, Chong Wha Baek, Jung Won Park, Yong Hun Jung, Young Cheol Woo, Jin Yun Kim, Sun Gyoo Park |
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Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Korea. koogillhoi@hanafos.com |
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| Abstract |
BACKGROUND
This study was designed to compare the effects of remifentanil, alfentanil, and fentanyl on the hemodynamic changes, sedation, and analgesia when administered with small doses of midazolam in patients undergoing a retrobulbar block for cataract surgery.
METHODS
Sixty patients scheduled for cataract surgery were divided into 4 groups (n = 15 for each group). Firstly, group C received 5 ml of a normal saline solution, 3 min before a retrobulbar block. Next, group R received remifentanil 0.3g/kg. Furthermore, group A received a 4.5g/kg dose of alfentanil, 90 s before a retrobulbar block, and group F received fentanyl 0.6g/kg, 210 s before a retrobulbar block. All solutions were mixed with normal saline to a 5 ml volume. In group R, A, and F, midazolam (0.5 mg for patients over the age of 65 years; 1.0 mg in patients under the age of 65 years) was injected 3 min before the retrobulbar block.
RESULTS
The systolic blood pressure in patients significantly increased at 1 or 2 minutes after a retrobulbar block in group C and at 1 minute in group F. For group R, the systolic blood pressure decreased significantly at 3, 4, 5, and 10 minutes, and at 2, 3, 4, 5, and 10 minute in group A. The mean OAA/S scale during a retrobulbar block significantly declined in groups R and A. The VAS score for pain was significantly lower in groups R and A, whereas the VAS anxiety index was significantly lower in groups R, A, F compared to group C (P 0.05).
CONCLUSIONS
We found that the combination of remifentanil or alfentanil with midazolam showed better hemodynamic stability, sedative, and analgesic effects compared to fentanyl with midazolam in the retrobulbar block for cataract surgery. |
| Key Words:
alfentanil; cataract; fentanyl; remifentanil; retrobulbar block |
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