Journal of Anesthesiology and Pain

Background:

Because general anesthesia is not a good choice in elderly ASA>II patients candidate for cataract surgery performored by ophthalmology Residents and lack of cooperation in these patients, sedative effect and hemodynamic status and side effects of two drugs, Remifentanil & propofol  are compared.

Methods :

In a Randomized clinical trial on 60 patients candidate for cataract surgery which were divided in two group each containing 30 patients were compared. In group A (remifentanil group), patients were sedated with a bolus dose of 0.5 µg/kg within 1 minute , and maintenance dose of 0.05 µg/kg/min. In group B ( propofol  group) ,  patients were sedated with a bolus dose of 0.25 µg/kg, and maintenance dose of 25 µg/kg/min. After retrobulbar block was performored for all the patients by residents. Hemodynamic responses, including  HR , DBP , SBP  and O2Sat and sedation level according to MOAA/SS  were measured .

Modified Observers Assessment of Awareness/Sedation Scale   =   MOAA/SS           

Results:

 Sedation was deeper in  group A  (Remifentanil ) measured in all times after Block and were statistically meaningful (p<0.05) .The heart rate was  reduced in  group A after 20 minutes after Block and were statistically meaningful ( p<0.05). 7 Cases  in group A ( Remifentanil ) had  nausea after drug administration  (P=0.011).

Conclusion:

 Remifentanil can induce high level of sedation for patients compare to propofol. But Nausea could be troublesome and in this point propofol has less adverse effect.