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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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