Analgesia for retrobulbar block--comparison of remifentanil, alfentanil and fentanyl

Middle East J Anaesthesiol. 2007 Oct;19(3):595-602.

Abstract

Background: The injection of retrobulbar block is associated with significant pain and discomfort. Therefore a short-acting IV analgesic before retrobulbar injection has been advocated.

Objective: To compare remifentanil, alfentanil and fentanyl in providing analgesia for retrobulbar block injection.

Methods: 69 patients were enrolled randomly into three groups of 23 each to receive either Remifentanil 1 microg/kg, Alfentanil 20 microg/kg or Fentanyl 2 microg/kg as an IV bolus dose prior to retrobulbar injection. Mean arterial pressure (MAP) and heart rate (HR) were recorded and Numerical Pain Score (NPS) were assessed by a blinded observer.

Results: Remifentanil prevented increase in MAP and HR while alfentanil and fentanyl were ineffective in this purpose (p < 0.05). NPS was significantly lower in remifentanil group (p < 0.05).

Conclusion: Remifentanil 1 microg/kg prior to retrobulbar injection provide excellent hemodynamic stability and ensure analgesia.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Alfentanil / administration & dosage
  • Alfentanil / adverse effects
  • Alfentanil / therapeutic use
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Anesthesia, Spinal / adverse effects*
  • Blood Pressure / drug effects
  • Double-Blind Method
  • Female
  • Fentanyl / administration & dosage
  • Fentanyl / adverse effects
  • Fentanyl / therapeutic use
  • Heart Rate / drug effects
  • Humans
  • Male
  • Ophthalmologic Surgical Procedures
  • Pain / etiology*
  • Pain / prevention & control*
  • Pain Measurement / drug effects
  • Piperidines / administration & dosage
  • Piperidines / adverse effects
  • Piperidines / therapeutic use
  • Remifentanil

Substances

  • Analgesics, Opioid
  • Piperidines
  • Alfentanil
  • Remifentanil
  • Fentanyl