Comparing the effects of remifentanil with fentanyl on pain intensity, hemodynamic status and post-anesthesia complications of cataract surgery candidates

Abstract

Due to the fact that in patients who undergo cataract surgery, proper ventilation and safe airway should be established for the patient during the surgery, so the use of a drug that can control the patient's sympathetic and at the same time help in the induction of the patient for anesthesia. It is very valuable and important and considering the limitations of relaxants in neuromuscular diseases, the aim of this study is to compare fentanyl with remifentanil (along with propofol as an induction and maintenance drug with isoflurane gas at a rate of 1% and for paralysis In the fentanyl group, the use of atracurium (remifentanil) is used instead of the relaxant. We examine this matter in terms of facilitating induction, reducing postoperative complications, and finally, the success of cataract surgery. Methods: This study, which is a randomized, double-blind clinical trial study with a prospective approach, was conducted with the participation of 400 patients who were candidates for cataract surgery. Patients were randomly assigned to two groups of fentanyl and remifentanil, and for both groups, induction of propofol and maintenance of anesthesia with isoflurane gas was 1%, and for paralysis in the fentanyl group, it was atracurium and no relaxant in the remifentanil group. In the fentanyl induction group with 1 mg of midazolam, 0.7 micrograms per kilogram of body weight of fentanyl, 1 to 2 mg per kilogram of body weight of propofol along with 1 mg per kilogram of patient body weight of lidocaine and finally 10 mg of atracurium was injected. In the remifentanil induction group, 1 mg of midazolam, 2 to 4 micrograms of remifentanil per kilogram of body weight, 1 to 2 mg of propofol per kilogram of body weight, and 1 mg of lidocaine per kilogram of patient body weight were injected. became. Then, the speed of the onset of anesthesia and the complications after the surgery were recorded in the recovery of the patients. Results: Irritability (P=0.014), the amount of relaxation medication needed (P=0.009) and the average relaxation medication (P=0.036) in the patients of the remifentanil group were significantly higher than in the patients group. It was fentanyl. Regurgitation between the two groups had no statistically significant difference (P=0.744), but nausea in the recovery unit (P=0.041) and the need for anti-nausea medication in the recovery unit (P=0.038). In the patients of the fentanyl group, it was significantly more than the remifentanil group. Heart rate and blood pressure (systolic and diastolic) in patients receiving remifentanil after induction of anesthesia (at all times) were significantly lower than in the fentanyl group. The average time of anesthesia after complete injection of propofol (P=0.041), recovery of breathing in patients (P=0.048) and the rate of recovery of consciousness in patients receiving remifentanil was significantly lower than in the fentanyl group (P=0.042).