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Abstract #10185 Published in IGR 6-1
Effects of remifentanil and fentanyl on intraocular pressure during the maintenance and recovery of anaesthesia in patients undergoing non-ophthalmic surgery
Sator-Katzenschlager SM; Oehmke MJ; Deusch E; Dolezal S; Heinze G; Wedrich AEuropean Journal of Anaesthesiology 2004; 21: 95-100
BACKGROUND AND OBJECTIVE: To compare the effects of remifentanil and fentanyl on intraocular pressure (IOP) during the maintenance and recovery of anaesthesia in patients undergoing elective non-ophthalmic surgery. METHODS: Thirty-two patients (ASA I-II) were randomized into two groups to receive either a continuous infusion of remifentanil (0.25-0.5 μg/kg-1 min-1, n = 16, Group R) or an intermittent bolus of fentanyl (2-5 μg/kg-1, n = 16, Group F) during the maintenance of anesthesia. For the induction of anesthesia, Group R received remifentanil 1 μg/kg-1 and Group F received fentanyl 2 μg/kg-1; both groups then received propofol 2 mg/kg-1 with vecuronium 0.1 mg/kg-1. Anesthesia in both groups was maintained with a continuous infusion of propofol 4-8 mg/kg-1 h-1. Ventilation of the lungs was controlled to a constant end-tidal PCO2 of 4.7-5.4 kPa. Blood pressure, electrocardiography, heart rate and oxygen saturation were monitored throughout anesthesia. IOP was determined before surgery, during the maintenance of anesthesia, two minutes after emergence and in the recovery room using a Perkins hand-held applanation tonometer by an ophthalmologist blinded to the anesthetic technique. RESULTS: After induction of anesthesia, a significant decrease in IOP in the remifentanil group from 13.6 ± 2.6 to 7.1 ± 3.1 mmHg (p < 0.001) and in the fentanyl group from 13.7 ± 2.2 to 9.7 ± 3.4 mmHg (p < 0.001) was observed and maintained during anesthesia. Thirty minutes after the end of anesthesia, IOP returned to baseline values in both groups (remifentanil: 13.9 ± 2.8 mmHg, p = 0.28; fentanyl: 13.6 ± 2.3 mmHg, p = 0.59). The IOP and hemodynamic variables did not differ significantly between the two groups (IOP, p = 0.7327; blood pressure, p = 0.1295; heart rate, p = 0.8601). CONCLUSION: Remifentanil maintains IOP at an equally reduced level compared with fentanyl.
Dr. M.J. Oehmke, Department of Anaesthesiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
Classification:
12.17 Anesthesia (Part of: 12 Surgical treatment)
