Analgesia for retrobulbar block--comparison of remifentanil, alfentanil and fentanyl.
BACKGROUND
The injection of retrobulbar block is associated with significant pain and discomfort. Therefore a short-acting IV analgesic before retrobulbar injection has been advocated.


OBJECTIVE
To compare remifentanil, alfentanil and fentanyl in providing analgesia for retrobulbar block injection.


METHODS
69 patients were enrolled randomly into three groups of 23 each to receive either Remifentanil 1 microg/kg, Alfentanil 20 microg/kg or Fentanyl 2 microg/kg as an IV bolus dose prior to retrobulbar injection. Mean arterial pressure (MAP) and heart rate (HR) were recorded and Numerical Pain Score (NPS) were assessed by a blinded observer.


RESULTS
Remifentanil prevented increase in MAP and HR while alfentanil and fentanyl were ineffective in this purpose (p < 0.05). NPS was significantly lower in remifentanil group (p < 0.05).


CONCLUSIONS
Remifentanil 1 microg/kg prior to retrobulbar injection provide excellent hemodynamic stability and ensure analgesia.
Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran. maghsodb@sums.ac.ir
Behzad
B
Maghsoudi
Mohammad Rez
MR
Talebnejad
Esfandyar
E
Asadipour
D000368:Aged; D015760:Alfentanil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement / Q000187:drug effects; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077208:Remifentanil
D000701:Analgesics, Opioid; D010880:Piperidines; D015760:Alfentanil; D000077208:Remifentanil; D005283:Fentanyl