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Propofol–remifentanil-based anaesthesia vs. sevoflurane–fentanyl-based anaesthesia for immediate postoperative ophthalmic evaluation following strabismus surgery

Published online by Cambridge University Press:  04 April 2006

V. G. Yazbeck-Karam ,
M. T. Aouad ,
J. H. Bleik  and
A. S. Baraka
V. G. Yazbeck-Karam
Affiliation:
Rizk Hospital, Department of Anesthesiology, Beirut, Lebanon American University of Beirut, Medical Centre, Department of Anesthesiology, Beirut, Lebanon
M. T. Aouad
Affiliation:
American University of Beirut, Medical Centre, Department of Anesthesiology, Beirut, Lebanon
J. H. Bleik
Affiliation:
Rizk Hospital, Department of ophthalmology, Beirut, Lebanon
A. S. Baraka
Affiliation:
American University of Beirut, Medical Centre, Department of Anesthesiology, Beirut, Lebanon
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Abstract

Summary

Background and objective: Following strabismus surgery, immediate postoperative ophthalmic evaluation may be desired. Thus, an anaesthetic technique allowing rapid recovery of ocular motility is required. Saccadic eye movements is a biophysical monitor of ocular motility and may be used to assess recovery from anaesthesia. The aim of this study is to compare the time to the recovery of saccadic eye movements in patients, following one of two anaesthetic techniques: Propofol–remifentanil-based anaesthesia vs. sevoflurane–fentanyl-based anaesthesia. Methods: Fifty adult patients undergoing strabismus surgery were randomly assigned to one of two groups: patients in Group R received induction and maintenance of anaesthesia with propofol and remifentanil, while patients in Group S received induction of anaesthesia with propofol and fentanyl and maintenance of anaesthesia with sevoflurane. Recovery from anaesthesia was measured from the time all anaesthetics were turned off and was assessed every 2 min. Recovery time was attained when patients were able to generate brisk saccadic eye movements. At recovery time, the ophthalmic evaluation was started. Results: The mean recovery time of saccadic eye movements was significantly shorter in the Group R when compared to the Group S (12.1 ± 4.3 min vs. 21.5 ± 4.7 min, respectively, P < 0.0001). More patients in Group S experienced nausea and vomiting postoperatively as compared to Group R (9/25 vs. 2/25, respectively, P = 0.037). Conclusions: Propofol–remifentanil-based anaesthesia may be a useful technique in strabismus surgery when immediate postoperative ophthalmic evaluation is desired. When compared to sevoflurane maintenance of anaesthesia, it allows for a more rapid recovery from anaesthesia as judged by recovery of saccadic eye movements and a decreased incidence of postoperative nausea and vomiting.

Keywords

ANAESTHETICS INHALATIONAL, sevofluraneANAESTHETICS INTRAVENOUS, propofolANALGESICS OPIOID, fentanyl, remifentanilSURGICAL TECHNIQUES, ophthalmic, strabismus surgeryPOSTOPERATIVE RECOVERY PERIOD
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 9 , September 2006 , pp. 743 - 747
Copyright
2006 European Society of Anaesthesiology

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