Aghadoost Dawood, Fazel Mohammad Reza, Fakharian Esmaiel
Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
Iran Red Crescent Med J. 2013 May;15(5):424-7. doi: 10.5812/ircmj.2316. Epub 2013 May 5.
The purpose of this study was to compare remifentanil versus propofol effect on pain and homodynamic in patients undergoing phacoemulsification with topical anesthesia.
A double blind clinical trial was conducted to research following the approval of the ethical committee research of the university. One hundred volunteer subjects were randomly assigned into two equal groups (n = 50). The subjects in the propofol group received 3mg/kg/hr while the patients in the remifentanil drug received 3 µg/kg/hr of this medication. Phaco time, blood pressure and heart rate before and after surgery, respiratory depression (O2 sat < 90%) and vomiting, pain scores, ophthalmologist satisfaction and demographic data were recorded.
The results of analysis showed that there were no significant differences between the age, sex, and duration of operation of the two treatment groups. Systolic, diastolic blood pressure and heart rate were significantly lower in the propofol group .The propofol group complained of pain than the remifentanil group (P = 0.001) while the surgeon satisfaction was higher for the remifentanil condition (P = 0.01). No significant differences were found between the two groups with respect to respiratory depression .No patient suffered from nausea and vomiting.
The results of this study indicated that using appropriate dose of remifentanil instead of propofol results in less pain, more stable homodynamic condition, and satisfaction of surgeon without no respiratory depression or perioperative nausea and vomiting.
本研究的目的是比较瑞芬太尼与丙泊酚对表面麻醉下白内障超声乳化手术患者疼痛及血流动力学的影响。
在大学伦理委员会研究批准后进行了一项双盲临床试验。100名志愿者受试者被随机分为两组,每组50人。丙泊酚组受试者接受3mg/kg/小时的剂量,而瑞芬太尼组患者接受3μg/kg/小时的该药物剂量。记录超声乳化时间、手术前后的血压和心率、呼吸抑制(血氧饱和度<90%)及呕吐情况、疼痛评分、眼科医生满意度和人口统计学数据。
分析结果显示,两个治疗组在年龄、性别和手术持续时间方面无显著差异。丙泊酚组的收缩压、舒张压和心率显著较低。丙泊酚组比瑞芬太尼组更易主诉疼痛(P = 0.001),而瑞芬太尼组外科医生的满意度更高(P = 0.01)。两组在呼吸抑制方面无显著差异。无患者出现恶心和呕吐。
本研究结果表明,使用适当剂量的瑞芬太尼而非丙泊酚可减少疼痛、使血流动力学状态更稳定、提高外科医生满意度,且无呼吸抑制或围手术期恶心呕吐。