Comparison of Sedation Efficacy Between Remifentanil and Dexmedetomidine in Arteriovenous Fistula Placement Surgery

Arteriovenous fistula (AVF) placement is a surgical procedure performed under local anesthesia and often without the need for muscle relaxants in patients with end-stage renal disease. The results of studies comparing remifentanil (REM) and dexmedetomidine (DEX) in patients undergoing AVF placement are controversial. The present study compared sedation efficacy between REM and DEX in patients undergoing AVF placement.

The present double-blind randomized clinical trial enrolled 40 patients in the operating room of Shahid Hashemi-Nejad Hospital in 2 groups and compared sedation between REM and DEX at different times during and after the surgery using a visual analog scale and the Ramsay score. The data were recorded and analyzed using SPSS, version 22.

The average pain score 120 minutes after the surgery was 4.9±0.72 and 4.3±0.80 in the DEX and REM groups, respectively (P=0.017). No significant difference was observed in the level of sedation between the 2 groups (P=0.113). The prevalence of tachycardia and bradycardia in the 2 groups was 10% (P=1.00) and 15% (P=1.00), respectively, and no significant difference was observed.

We found no significant differences between DEX and REM concerning sedation efficacy. Further studies with larger sample sizes in each group of patients and different procedural scenarios are recommended.