International Journal of Anesthesia and Clinical Medicine

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Comparison of Sedative Effect of Fentanil and Remifentanil during Phacoemulsification with Local Anesthesia

Received: 21 July 2014    Accepted: 09 August 2014    Published: 30 August 2014
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Abstract

Nowadays, Phacoemulsification surgery is mostly carried out under local anesthesia. In this type of anesthesia the patient needs to be sedated. Because of painful intracameral injection, an Intravenus (IV) analgesia is also required using bolus dose of Fentanil or Remifentanil. Our main purpose was the comparison of the sedative effects of 2 models of Intravenous local analgesia during Phacoemulsification in cataractus patients. Moreover , to investigate the patient, surgeon satisfaction and complication rate in two groups. Material and methods: This Clinical Trial study was carried out on 64 patients with cataract who underwent phacoemulsification surgery in Baqiyatallah hospital in second half of year 2013. Patients with American Society of Anesthesiologists (ASA) Physical Status classification system ; ASA class I & II were chosen and randomly divided into two groups. The level of sedation was assessed using the Ramsay sedation(RS) scale. Moreover , along with sedative effect, patient, surgeon satisfaction ,Vital signs, rate of pain and complication rate were recorded and compared in two groups. Results: Thirty six patients were in Fentanil group with mean age of 64.71± 8.21 years and 28 in Remifentanil group with mean age of 65.2 ± 12.43. RS in Fentanil group was significantly higher than Remifentanil group (2.02±1.08 versus 1.42±1.19, p<.05). Rate of satisfaction of patients and surgeons was significantly higher in Fentanil group in comparison with Remifentanil group (p<.05). Side effects in Fentanil group was also significantly less than Remifentanil (p<.05). There was no significant difference in vital signs of patients in two groups neither before surgery nor after that. Conclusion: Results of this study show that, Fentanil has fewer side effects, more sedation effect and more patient and surgeon satisfaction in comparison with Remifentanil. The administration of fentanil appears to be a better choice as an analgesic with local anesthesia in cataract surgery

DOI 10.11648/j.ja.20140203.11
Published in International Journal of Anesthesia and Clinical Medicine (Volume 2, Issue 3, May 2014)
Page(s) 22-26
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Fentanil, Remifentanil, Cataract, Phacoemulsification, Sedation, Local Anesthesia

References
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[2] Miller RD. Anesthesia. 7th ed. USA: Churchill Livingstone; 2010. pp. 769. Chapter 27
[3] Ezra DG1, Allan BD.Topical anaesthesia alone versus topical anaesthesia with intracameral lidocaine for phacoemulsification. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD005276.
[4] Ryu JH1, So YM, Hwang JW, Do SH.Optimal target concentration of remifentanil during cataract surgery with monitored anesthesia care. J Clin Anesth. 2010 Nov;22(7):533-7
[5] Hoke JF, Cunningham F, James MK, Muir KT, Hoffman WE (April 1997). "Comparative pharmacokinetics and pharmacodynamics of remifentanil, its principle metabolite (GR90291) and alfentanil in dogs". J. Pharmacol. Exp. Ther. 281 (1): 226–32.
[6] Patel SS, Spencer CM (Sep 1996). "Remifentanil". Drugs 52 (3): 417–27.
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[8] Caputi FF1, Lattanzio F, Carretta D, Mercatelli D, Candeletti S, Romualdi P.Morphine and fentanyl differently affect MOP and NOP gene expression in human neuroblastoma SH-SY5Y cells. J Mol Neurosci. 2013 Oct;51(2):532-8..
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[17] Weale NK, Rogers CA, Cooper R, Nolan J, Wolf AR (February 2004). "Effect of remifentanil infusion rate on stress response to the pre-bypass phase of paediatric cardiac surgery". Br J Anaesth 92 (2): 187–94.
[18] Lundgren S, Rosenquist JB: Amnesia, pain experience, and patient satisfaction after sedation with intravenous diazepam. J Oral Maxillofac Surg 41:99, 1983. PUBMED Abstract
[19] Lundgren S, Rosenquist JB: Comparison of sedation, amnesia, and patient comfort produced by intravenous and rectal diazepam. J Oral Maxillofac Surg 42:646, 1984. PUBMED Abstract
[20] Aydin ON, Kir E, Ozkan SB, Gürsoy F. Patient-controlled analgesia and sedation with fentanyl in phacoemulsification under topical anesthesia. J Cataract Refract Surg. 2002 Nov;28(11):1968-72.
[21] Singh R1, Ghazanwy M, Vajifdar H.A randomized controlled trial to compare fentanyl-propofol and ketamine-propofol combination for procedural sedation and analgesia in laparoscopic tubal ligation. Saudi J Anaesth. 2013 Jan;7(1):24-8.
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Author Information
  • Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran, Iran

  • Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran, Iran

  • Department of Ophthalmology, Bina Eye Hospital Research center, Tehran, Iran

  • Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Bina Eye Hospital Research Center, Tehran, Iran

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    Aliagha Alishiri, Mohammadjavad Foruzanmehr, Seyed Aliasghar Mosavi, Abaszadeh Mehrdad. (2014). Comparison of Sedative Effect of Fentanil and Remifentanil during Phacoemulsification with Local Anesthesia. International Journal of Anesthesia and Clinical Medicine, 2(3), 22-26. https://doi.org/10.11648/j.ja.20140203.11

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    Aliagha Alishiri; Mohammadjavad Foruzanmehr; Seyed Aliasghar Mosavi; Abaszadeh Mehrdad. Comparison of Sedative Effect of Fentanil and Remifentanil during Phacoemulsification with Local Anesthesia. Int. J. Anesth. Clin. Med. 2014, 2(3), 22-26. doi: 10.11648/j.ja.20140203.11

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    AMA Style

    Aliagha Alishiri, Mohammadjavad Foruzanmehr, Seyed Aliasghar Mosavi, Abaszadeh Mehrdad. Comparison of Sedative Effect of Fentanil and Remifentanil during Phacoemulsification with Local Anesthesia. Int J Anesth Clin Med. 2014;2(3):22-26. doi: 10.11648/j.ja.20140203.11

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  • @article{10.11648/j.ja.20140203.11,
      author = {Aliagha Alishiri and Mohammadjavad Foruzanmehr and Seyed Aliasghar Mosavi and Abaszadeh Mehrdad},
      title = {Comparison of Sedative Effect of Fentanil and Remifentanil during Phacoemulsification with Local Anesthesia},
      journal = {International Journal of Anesthesia and Clinical Medicine},
      volume = {2},
      number = {3},
      pages = {22-26},
      doi = {10.11648/j.ja.20140203.11},
      url = {https://doi.org/10.11648/j.ja.20140203.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ja.20140203.11},
      abstract = {Nowadays, Phacoemulsification surgery is mostly carried out under local anesthesia. In this type of  anesthesia the patient needs to be sedated. Because  of   painful intracameral injection, an Intravenus (IV) analgesia is also required using  bolus dose of Fentanil or  Remifentanil. Our main purpose was  the comparison of  the  sedative effects of 2 models of Intravenous  local analgesia during  Phacoemulsification in cataractus patients. Moreover , to investigate the patient, surgeon satisfaction and complication rate in two groups. Material and methods: This Clinical Trial study was carried out on 64 patients with cataract who underwent phacoemulsification surgery in Baqiyatallah hospital in second half of year 2013. Patients with American Society of Anesthesiologists (ASA) Physical Status classification system ; ASA class I & II were chosen and randomly divided into two groups. The level of sedation was assessed using the Ramsay sedation(RS) scale. Moreover , along with sedative effect, patient, surgeon satisfaction ,Vital signs, rate  of pain and complication rate were recorded  and compared in two groups. Results: Thirty six patients were in Fentanil group with  mean age of  64.71± 8.21 years and 28 in Remifentanil group with  mean age of  65.2 ± 12.43. RS in Fentanil group was significantly higher than Remifentanil group (2.02±1.08 versus  1.42±1.19, p<.05). Rate of satisfaction of patients and surgeons was significantly higher in Fentanil group in comparison with Remifentanil group (p<.05). Side effects in Fentanil group was also significantly less than Remifentanil (p<.05). There was no significant difference in vital signs of patients in two groups neither before surgery nor after that. Conclusion: Results of this study show that, Fentanil has fewer side effects, more sedation effect and more patient and surgeon satisfaction in comparison with Remifentanil. The administration of fentanil appears to be a better choice as an analgesic with local anesthesia in cataract surgery},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Comparison of Sedative Effect of Fentanil and Remifentanil during Phacoemulsification with Local Anesthesia
    AU  - Aliagha Alishiri
    AU  - Mohammadjavad Foruzanmehr
    AU  - Seyed Aliasghar Mosavi
    AU  - Abaszadeh Mehrdad
    Y1  - 2014/08/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ja.20140203.11
    DO  - 10.11648/j.ja.20140203.11
    T2  - International Journal of Anesthesia and Clinical Medicine
    JF  - International Journal of Anesthesia and Clinical Medicine
    JO  - International Journal of Anesthesia and Clinical Medicine
    SP  - 22
    EP  - 26
    PB  - Science Publishing Group
    UR  - https://doi.org/10.11648/j.ja.20140203.11
    AB  - Nowadays, Phacoemulsification surgery is mostly carried out under local anesthesia. In this type of  anesthesia the patient needs to be sedated. Because  of   painful intracameral injection, an Intravenus (IV) analgesia is also required using  bolus dose of Fentanil or  Remifentanil. Our main purpose was  the comparison of  the  sedative effects of 2 models of Intravenous  local analgesia during  Phacoemulsification in cataractus patients. Moreover , to investigate the patient, surgeon satisfaction and complication rate in two groups. Material and methods: This Clinical Trial study was carried out on 64 patients with cataract who underwent phacoemulsification surgery in Baqiyatallah hospital in second half of year 2013. Patients with American Society of Anesthesiologists (ASA) Physical Status classification system ; ASA class I & II were chosen and randomly divided into two groups. The level of sedation was assessed using the Ramsay sedation(RS) scale. Moreover , along with sedative effect, patient, surgeon satisfaction ,Vital signs, rate  of pain and complication rate were recorded  and compared in two groups. Results: Thirty six patients were in Fentanil group with  mean age of  64.71± 8.21 years and 28 in Remifentanil group with  mean age of  65.2 ± 12.43. RS in Fentanil group was significantly higher than Remifentanil group (2.02±1.08 versus  1.42±1.19, p<.05). Rate of satisfaction of patients and surgeons was significantly higher in Fentanil group in comparison with Remifentanil group (p<.05). Side effects in Fentanil group was also significantly less than Remifentanil (p<.05). There was no significant difference in vital signs of patients in two groups neither before surgery nor after that. Conclusion: Results of this study show that, Fentanil has fewer side effects, more sedation effect and more patient and surgeon satisfaction in comparison with Remifentanil. The administration of fentanil appears to be a better choice as an analgesic with local anesthesia in cataract surgery
    VL  - 2
    IS  - 3
    ER  - 

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