Alfentanil/promazine versus meperidine/promazine as a sedative regimens during local analgesia for cataract operation.
The influence of two intravenous (IV) sedative regimens on intra-ocular pressure (IOP) was investigated in conjunction with retrobulbar local analgesia. Forty patients of either sex, and similar age with body weight within 40-90 kg were allocated equally and randomly to two groups: Group A (alfentanil/promazine) and group M (meperidine/promazine). Measurement of IOP, systolic pressure, pulse rate, respiratory rate, PaCO2, PaO2 and O2 saturation were made before operation, after premedication, after IV sedation and post-operatively. In the Alfentanil group there was significantly stronger decrease of IOP (p < 0.001). In group A the IOP dropped from 18.1 +/- 3.2 mm Hg to 10.3 +/- 2.7 mm Hg, i.e. 43%, while in group M the reduction IOP was from 17.6 +/- 3.5 mm Hg to 12.6 +/- 1.9 mm Hg, i.e. 28.4%. Meperidine caused a significant increase in PaCO2 (4.2 +/- 0.3 mm Hg), however this increase was not sufficient to cause the IOP alterations. The oxygen saturation was lower in group M (decreased by 1.5 +/- 1% in group M versus decrease by 1.0 +/- 1.2% in group A). Cardiovascular parameters were more stable in group A. In conclusion the alfentanil regimen produced a better reduction of the IOP with excellent sedation, operative condition and least anaesthetic side effects.
el-Bassiouny
O
O
Department of Ophthalmology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
el-Taher
E M
EM
el-Din ABD el-Ghaffar
M E
ME
D000368:Aged; D015760:Alfentanil / Q000008:administration & dosage*; D000698:Analgesia; D000772:Anesthesia, Local / Q000379:methods*; D001794:Blood Pressure; D002387:Cataract Extraction; D004338:Drug Combinations; D005260:Female; D006339:Heart Rate; D006801:Humans; D007275:Injections, Intravenous; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy; D011395:Promazine / Q000008:administration & dosage*; D012119:Respiration
D004338:Drug Combinations; D015760:Alfentanil; D008614:Meperidine; D011395:Promazine