title: Increase in intraocular pressure is less with propofol and remifentanil than isoflurane with remifentanil during cataract surgery: A randomized controlled trial.
abstract: BACKGROUND
  This double-blinded, randomized clinical trial was designed to evaluate intraocular pressure (IOP) change in cataract surgery using the combination of propofol and remifentanil or the combination of isoflurane and remifentanil.
  
  
  METHODS
  One hundred sixty patients were randomly allocated to a maintenance anesthetic consisting of remifentanil + isoflurane (group I), normal saline + isoflurane (group II), propofol + remifentanil (group III) or normal saline + propofol (group IV). IOP was measured at seven predefined time points, baseline (T0), 3 min after the start of continuous remifentanil infusion (T2), after induction of anesthesia (T3), immediately after laryngoscopy and intubation (T4), 5 min after laryngoscopy (T5), immediately after the block of continuous remifentanil infusion (T6) and 3 min after T6 (T7). Outcomes included IOP, systole blood pressure (SBP) and diastole blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR).
  
  
  RESULTS
  The mean of IOP in Group III was lower than other groups and in group IV was higher than other groups. At time point T4 and T5 differences in the mean of IOP between groups III and IV was significantly different (P > 0.05). The trend in changes in the mean of IOP was statistically significant among groups (P value = 0.01). The trends in changes in the mean of SBP, DBP and MAP were not significantly different among groups (P value = 0.41). HR in group III was significantly lower than other groups. The trend in changes in the mean of HR was significantly different among groups (P value = 0.002).
  
  
  CONCLUSIONS
  Propofol with remifentanil was more effective than placebo or adding remifentanil to isoflurane in management of IOP in cataract surgery.
authors: Department of Anesthesiology and Critical Care, School of Medicine and Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Kamran
authors: K
authors: Montazeri
authors: Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Alireza
authors: A
authors: Dehghan
authors: Department of Anaesthesiology and Anaesthesiology and Intensive Care Unit, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Saeed
authors: S
authors: Akbari
keywords: Cataract; intraocular pressure; isoflurane; propofol; remifentanil