Remifentanil versus propofol on pain and hemodynamic in patients under phacoemulsifiشcation with topical anesthesia

To evaluate the effect of propofol and remifentanil on pain and hemodynamic in patients under phacoemulsification with topical anesthesia.

After Ethic’s committee approval in a clinical trial study, 100 consecutive patients scheduled for phacoemulsification were randomized to 2 groups in a prospective manner. Each group received intravenous infusion 3 mg/kg/h propofol or 3 µ/kg/h remifentanil. Phaco time, blood pressure and heart rate before and after surgery, number of patients with respiratory depression (O2 sat<90%) and vomiting, pain scores, ophthalmologist satisfaction and demographic data were recorded.

Mean age, sex and phaco time were equal in the two groups. Systolic and diastolic blood pressure and heart rate were decreased significantly (p<0.05) in propofol group but this difference in remifentanil was not significant. Patients had more pain in propofol group (p=0.001) and the surgeon satisfaction was higher in remifentanil group (p=0.01). Two patients in the remifentanil group had respiratory depression but the difference was not statistically significant (p>0.05). Perioperative vomiting was not found in any groups.

With the doses used in this study, It was shown that remifentanil was more effective than propofol in minimizing pain and hemodynamic stability without producing excessive, respiratory depression or perioperative nausea and vomiting.