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Remifentanil for analgesia during retrobulbar nerve block placement

Published online by Cambridge University Press:  13 April 2005

W. Leidinger ,
P. Schwinn ,
H.-M. Hofmann  and
J. N. Meierhofer
W. Leidinger
Affiliation:
Teaching Hospital of the Ludwig-Maximilian-University Munich, Department of Anaesthesiology and Intensive Care Unit – Blood Bank, Garmisch-Partenkirchen, Klinikum Garmisch-Partenkirchen, Germany
P. Schwinn
Affiliation:
Teaching Hospital of the Ludwig-Maximilian-University Munich, Department of Anaesthesiology and Intensive Care Unit – Blood Bank, Garmisch-Partenkirchen, Klinikum Garmisch-Partenkirchen, Germany
H.-M. Hofmann
Affiliation:
Teaching Hospital of the Ludwig-Maximilian-University Munich, Department of Ophthalmology, Klinikum Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
J. N. Meierhofer
Affiliation:
Teaching Hospital of the Ludwig-Maximilian-University Munich, Department of Anaesthesiology and Intensive Care Unit – Blood Bank, Garmisch-Partenkirchen, Klinikum Garmisch-Partenkirchen, Germany
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Summary

Background and objectives: Patients undergoing eye surgery under regional anaesthesia often require concomitant medication for analgesia and comfort. Remifentanil, with its ultra-short acting-profile, may be useful to reduce pain during retrobulbar nerve block for cataract surgery.

Methods: We performed a prospective, randomized, double-blind study to compare the efficacy of remifentanil for analgesia during retrobulbar nerve block placement. Ninety patients undergoing cataract surgery were randomly divided to receive either remifentanil 0.3 μg kg−1 (n = 45) or an equivalent volume of saline (n = 45). The injection was administered within 30 s in both groups. Patients rated their amount of pain on a 10 cm visual analogue scale. Respiratory frequency, oxygen saturation, cardiac rhythm and postoperative nausea and vomiting (PONV) were recorded.

Results: The mean visual analogue score in the Remifentanil group was 2.56; it was 5.51 in the Saline group (P = 0.001, U-test). Three patients developed bradycardia and three had PONV in the Remifentanil group. Two patients developed tachycardia and one had PONV in the Saline group. No patient developed respiratory depression.

Conclusion: In patients undergoing retrobulbar block placement for eye surgery, 0.3 μg kg−1 remifentanil over 30 s significantly reduced their reported pain. In addition, remifentanil did not increase the risk of untoward side-effects.

Keywords

ANAESTHESIA, retrobulbarANAESTHETICS, INTRAVENOUS, remifentanilOPHTHALMIC SURGERY, cataract
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 1 , January 2005 , pp. 40 - 43
Copyright
© 2005 European Society of Anaesthesiology

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References

Merriam JC, Zheng L, Merriam JE, Zaider M, Lindstrom B. The effect of incisions for cataract on corneal curvature. Ophthalmology 2003; 110: 1807–1813.Google Scholar
Kallio H, Uusitalo RJ, Maunuksela EL. Topical anesthesia with or without propofol sedation versus retrobulbar/peribulbar anesthesia for cataract extraction: prospective randomized trial. J Cataract Refract Surg 2001; 27: 1372–1379.Google Scholar
Boezaart A, Berry R, Nell M. Topical anesthesia versus retrobulbar block for cataract surgery: the patients' perspective. J Clin Anesth 2000; 12: 58–60.Google Scholar
Guzey M, Satici A, Dogan Z, Karadede S. The effects of bupivacaine and lidocaine on the corneal endothelium when applied into the anterior chamber at the concentrations supplied commercially. Ophthalmologica 2002; 216: 113–117.Google Scholar
Mingus ML, Monk TG, Gold MI, Jenkins W, Roland C. Remifentanil versus propofol as adjuncts to regional anesthesia. Remifentanil 3010 Study Group. J Clin Anesth 1998; 10: 46–53.Google Scholar
Lauwers MH, Vanlersberghe C, Camu F. Comparison of remifentanil and propofol infusions for sedation during regional anesthesia. Reg Anesth Pain Med 1998; 23: 64–70.Google Scholar
Kapila A, Glass PS, Jacobs JR, et al. Measured contextsensitive half-times of remifentanil and alfentanil. Anesthesiology 1995; 83: 968–975.Google Scholar
Gold MI, Watkins WD, Sung YF, et al. Remifentanil versus remifentanil/midazolam for ambulatory surgery during monitored anesthesia care. Anesthesiology 1997; 87: 51–57.Google Scholar
Boezaart AP, Berry RA, Nell ML, van Dyk AL. A comparison of propofol and remifentanil for sedation and limitation of movement during periretrobulbar block. J Clin Anesth 2001; 13: 422–426.Google Scholar
Holas A, Krafft P, Marcovic M, Quehenberger F. Remifentanil, propofol or both for conscious sedation during eye surgery under regional anaesthesia Eur J Anaesthesiol 1999; 16: 741–748.Google Scholar
Atkinson WS. Local anesthesia in ophthalmology. Am J Ophthalmol 1948; 31: 1607–1618.Google Scholar
Hamilton RC. Techniques of orbital regional anaesthesia. Br J Anaesth 1995; 75: 88–92.Google Scholar
Hessemer V. Peribulbar anesthesia vs. retrobulbar anesthesia with facial nerve block. Techniques, local anesthetics and additives, akinesia and sensory block, complications (German). Klin Monatsbl Augenheilkd 1994; 204: 75–89.Google Scholar
Boezaart AP, Berry RA, Laubscher JJ, Nell ML. Evaluation of anxiolysis and pain associated with combined peri- and retrobulbar eye block for cataract surgery. J Clin Anesth 1998; 10: 204–210.Google Scholar
Rewari V, Madan R, Kaul HL, Kumar L. Remifentanil and propofol sedation for retrobulbar nerve block. Anaesth Intensive Care 2002; 30: 433–437.Google Scholar
Heine G, Gabriel H, Weindler J, Ruprecht KW, Kindermann W. Painful regional anaesthesia induces an immunological stress reaction: the model of retrobulbar anaesthesia. Eur J Anaesthesiol 2001; 18: 505–510.Google Scholar
Servin FS, Raeder JC, Merle JC, et al. Remifentanil sedation compared with propofol during regional anaesthesia. Acta Anaesthesiol Scand 2002; 46: 309–315.Google Scholar