Usage of remifentanil and fentanyl in intravenous patient-controlled sedo-analgesia.
Our aim was to investigate the effects of patient-controlled sedo/analgesia with fentanyl or remifentanil during cataract surgery with phacoemulsification method under topical anaesthesia. The ethical committee has approved the prospective, randomized, double-blind study. ASA I-III, 120 patients underwent cataract surgery were randomly allocated to 3 groups. Fentanyl was administered in 0.7 microg/kg loading, 10 microg bolus dose with 5 minutes lockout time, remifentanil was administered 0.3 microg/kg loading, 20 microg bolus dose with 3 minutes lockout time by patient controlled analgesia (PCA) equipment. In the control group, saline solution was given without any analgesic drug. Cardiorespiratory system findings, verbal pain scale and sedation scores were recorded preoperatively and intraoperatively at the 5th, 10th, 15th, 20th and 30th minutes. Discomfort during surgery, pressing the PCA button, and complications were recorded. The verbal pain scale scores was significantly lower in the drug groups than the those in control group at the 15th minute. The sedation scores was significantly higher in the remifentanil group at the 5th minute (p=0.019) and in the fentanyl group at the 10th minute (p=0.007) than those in the control group. The number of patients pressing the PCA button was much higher in the control group than the drug groups (p<0.05). Patient comfort and surgeon satisfaction were higher in the drug groups (p<0.05). Intravenous-PCA sedo/analgesia addition to topical anaesthesia provides an advantage in sedo/analgesia, patient comfort, and surgeon satisfaction. PCA is a convenient and safe method, especially at the beginning of the operation when anxiety is intense, and during healon/lens implantation.
Akgül
Ayten
A
Department of Anaesthesiology and Reanimation, Aydin, Turkey.
Aydin
Osman Nuri
ON
Dayanir
Volkan
V
Sen
Selda
S
Ugur
Bakiye
B
Kir
Erkin
E
D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002387:Cataract Extraction; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage*; D011446:Prospective Studies; D000077208:Remifentanil; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl