Alfentanil/promazine versus meperidine/promazine as a sedative regimens during local analgesia for cataract operation

Abstract

The influence of two intravenous (IV) sedative regimens on intra-ocular pressure (IOP) was investigated in conjunction with retrobulbar local analgesia. Forty patients of either sex, and similar age with body weight within 40-90 kg were allocated equally and randomly to two groups: Group A (alfentanil/promazine) and group M (meperidine/promazine). Measurement of IOP, systolic pressure, pulse rate, respiratory rate, PaCO2, PaO2 and O2 saturation were made before operation, after premedication, after IV sedation and post-operatively. In the Alfentanil group there was significantly stronger decrease of IOP (p < 0.001). In group A the IOP dropped from 18.1 +/- 3.2 mm Hg to 10.3 +/- 2.7 mm Hg, i.e. 43%, while in group M the reduction IOP was from 17.6 +/- 3.5 mm Hg to 12.6 +/- 1.9 mm Hg, i.e. 28.4%. Meperidine caused a significant increase in PaCO2 (4.2 +/- 0.3 mm Hg), however this increase was not sufficient to cause the IOP alterations. The oxygen saturation was lower in group M (decreased by 1.5 +/- 1% in group M versus decrease by 1.0 +/- 1.2% in group A). Cardiovascular parameters were more stable in group A. In conclusion the alfentanil regimen produced a better reduction of the IOP with excellent sedation, operative condition and least anaesthetic side effects.

Beyond Pain, Fear, Withdrawal-Findings, And Problems Involving Change - Treatment and Application for A Chronic Addiction on Alcohol Do Not End

“…The drug may be given parenterally when the patient is unable to take it orally. If anything, the drug seems more effective than chlorpromazine in controlling psychomotor hyperactivity and other symptoms of the acute and post withdrawal phases [12]. The hypotension and compensatory tachycardia are less pronounced and gastric symptoms are efficiently controlled.…”

“…Promazine (Sparine) has been used in the treatment of alcoholism [12]. The indications for its use are identical with those of chlorpromazine.…”

Anaesthetic Management in Cataract Surgery

“…Doses of 25 to 50 μg repeated in the case of pain are usually sufficient for the majority of patients (Aydin et al, 2002). Alfentanil and promazine in combination produce a superior quality of sedation, operating conditions and a milder side effect profile when compared with meperidine-promazine (el-Bassiouny et al, 1992). Remifentanil, a shorter acting opioid derivate, which undergoes metabolism by plasma esterase can be used solely or as a complementary drug.…”