Satisfaction in patients with chronic renal failure during the surgical creation of an arteriovenous fistula under monitored anesthesia care using remifentanil

ABSTRACT

BACKGROUND: Remifentanil is a rapid and short-acting drug that can be used for analgesia and sedation during monitored anesthesia care. This study was designed to evaluate the effect of remifentanil on pain and satisfaction of patients during creation of an arterio-venous fistula (AVF). METHODS: Forty chronic renal failure (CRF) patients, undergoing creation of an AVF, were assigned to receive remifentanil (0.05 microg/kg/min) (group R) or saline infusion (group S). Systolic blood pressure, diastolic blood pressure, heart rate, SpO2, Observer's Assessment Alertness/Sedation scale score, respiratory depression, dizziness, nausea and vomiting, pain intensity and frequency, satisfaction score, and operating time were measured. RESULTS: Pain frequency in group R was lower than group S (P < 0.01). The median (interquartile ranges) of pain frequency was 0 (0, 1) in group R and 1 (0.5, 4.0) in group S. In group R, 6 patients experienced respiratory depression, but responded readily to calling of the name in normal tone and recovered well. Satisfaction scores in group R were higher than that of group S (P < 0.05). The median (interquartile ranges) satisfaction score was 4.5 (4, 5) in group R and 4 (3.0, 4.5) in group S. There were no differences in others between the two groups. CONCLUSIONS: Remifentanil infusion at the rate of 0.05 microg/kg/min effectively reduces pain and increases satisfaction of CRF patients during the creation of an AVF.