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

ABSTRACT

The injection of retrobulbar block is associated with significant pain and discomfort. Therefore a short-acting IV analgesic before retrobulbar injection has been advocated. To compare remifentanil, alfentanil and fentanyl in providing analgesia for retrobulbar block injection. 69 patients were enrolled randomly into three groups of 23 each to receive either Remifentanil 1 micro g/kg, Alfentanil 20 micro g/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. 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]. Remifentanil 1 microg/kg prior to retrobulbar injection provide excellent hemodynamic stability and ensure analgesia