Comparison between remifentanil, propofol or both for sedation during retrobulbar nerve block

To compare between the efficacy of remifentanil and propofol and combination of both for analgesia during retrobulbar nerve block in cataract surgery. A prospective randomised double blind study conducted in King Hussein Medical Center in Royal Medical Services during the period between September 2004 and August 2005. 160 patients undergoing extra capsular cataract extraction surgery under retrobulbar anaesthesia were enrolled in the study. Patients were randomly divided into four groups [40 patients in each group] and received different drug combinations by the same anaesthetist as follows: remifentanil 0.3 microgram/kg [group 1], propofol 0.5 mg/kg [group 2], remifentanil 0.3 microgram/kg and propofol 0.5 mg/kg [group 3] and saline 0.1 ml/kg as a placebo [group 4]. Patient's movement and pain were observed during the injection. Heart rate, respiratory rate and haemoglobin oxygen saturation were observed every minute for 10 minutes after the block. No significant movement occurred in group 3 during the placement of the block compared to half of the patients in the control group. The mean visual analogue score was 2.3 in group 3 compared to 6.7 in group 4. There was no significant change in mean heart and respiratory rates and haemoglobin oxygen saturation among the three study groups. Patients undergoing cataract surgery under retrobulbar anaesthesia, a combination of remifentanil 0.3 microgram/kg and propofol 0.5 mg/kg is considered to provide excellent relief of pain with least patient movement and minimal respiratory and cardiac side effects

Sub anesthetic dose of propofol in eye surgery

To examine the efficacy and safety of sub-anesthetic dose of propofol for reducing patient awareness during peribulbar anesthesia in eye surgery. This study was conducted on 400 patients scheduled for elective cataract surgery at King Hussein Medical Center between August 2004 and May 2005 using peribulbar anesthesia. Patients were allocated to two groups. Two hundred patients received 0.5mg/kg propofol [group P] and the rest of patients didn't receive any sedation [group N]. Vital signs were monitored with continuous pulse oximetry and blood pressure measurements. Efficacy of sedation was assessed by recording patient recall of peribulbar block after 10 minutes of injection. Propofol was effective in reducing recall in 80% of patients in-group P. No major side effects were encountered. Propofol is safe and efficacious in reducing recall of anesthetic injection without major side effects