Use of piritramide for analgesia and sedation during peribulbar nerve block for cataract surgery.
OBJECTIVE
To investigate the effects of pre-block analgesia and sedation using piritramide on haemodynamic stability, endocrine stress response and patients' pain perception.


METHODS
In a randomized, single-blinded, placebo-controlled study, 60 patients having cataract surgery with peribulbar block were randomly assigned into two groups: group A (n = 30) received 0.05 mg/kg piritramide (Dipidolor) intravenously; group B received normal saline intravenously prior to peribulbar block. Mean arterial pressure, heart rate, respiratory rate and pulse oximetry were recorded perioperatively. Pain from peribulbar block was assessed using a verbal analogue scale. Urinary excretion of vanillylmandelic acid was measured to assess the endocrine stress response. Using a questionnaire, patients assessed their anxiety and back pain before and during surgery.


RESULTS
Mean arterial pressure remained near baseline in group A. In group B, a significant increase in mean arterial pressure after peribulbar block was found (p < 0.001). In addition, a significant increase in urinary excretion of vanillylmandelic acid was found in group B (p = 0.013). Pain scores (p < 0.001), anxiety before nerve block (p = 0.02) and during surgery (p < 0.001) and back pain (p = 0.003) were significantly lower in group A.


CONCLUSIONS
The presented study suggests that using piritramide for analgesia and sedation prior to peribulbar block produces haemodynamic stability and reduces pain perception and endocrine stress response.
Department of Ophthalmology, University of Leipzig, Germany.
Sebastian
S
Reinhardt
Ulrich
U
Burkhardt
Andrei
A
Nestler
Renate
R
Wiedemann
D000368:Aged; D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000627:therapeutic use; D001007:Anxiety / Q000517:prevention & control; D001340:Autonomic Nerve Block / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology; D016292:Procedural Sedation / Q000379:methods*; D005123:Eye / Q000294:innervation; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D018918:Phacoemulsification; D010892:Pirinitramide / Q000627:therapeutic use*; D011446:Prospective Studies; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D014642:Vanilmandelic Acid / Q000652:urine
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D010892:Pirinitramide; D014642:Vanilmandelic Acid