Remifentanil for analgesia during retrobulbar nerve block placement.
OBJECTIVE
Patients undergoing eye surgery under regional anaesthesia often require concomitant medication for analgesia and comfort. Remifentanil, with its ultra-short acting-profile, may be useful to reduce pain during retrobulbar nerve block for cataract surgery.


METHODS
We performed a prospective, randomized, double-blind study to compare the efficacy of remifentanil for analgesia during retrobulbar nerve block placement. Ninety patients undergoing cataract surgery were randomly divided to receive either remifentanil 0.3 microg kg(-1) (n = 45) or an equivalent volume of saline (n = 45). The injection was administered within 30 s in both groups. Patients rated their amount of pain on a 10 cm visual analogue scale. Respiratory frequency, oxygen saturation, cardiac rhythm and postoperative nausea and vomiting (PONV) were recorded.


RESULTS
The mean visual analogue score in the Remifentanil group was 2.56; it was 5.51 in the Saline group (P = 0.001, U-test). Three patients developed bradycardia and three had PONV in the Remifentanil group. Two patients developed tachycardia and one had PONV in the Saline group. No patient developed respiratory depression.


CONCLUSIONS
In patients undergoing retrobulbar block placement for eye surgery, 0.3 microg kg(-1) remifentanil over 30 s significantly reduced their reported pain. In addition, remifentanil did not increase the risk of untoward side-effects.
Leidinger
W
W
Department of Anaesthesiology, and Intensive Care Unit-Blood Bank, Klinikum Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany. werner.leidinger@klinikum-gap.de
Schwinn
P
P
Hofmann
H M
HM
Meierhofer
J N
JN
D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D002387:Cataract Extraction; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D009407:Nerve Block / Q000009:adverse effects*; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011446:Prospective Studies; D000077208:Remifentanil
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil