EAJAIC

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

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Original Article
Comparison of the use of remifentanil in infusion and patient-controlled methods for sedation purposes
Aims: In this study, the infusion and patient-controlled with PCA device use of remifentanil used for sedation were compared in patients who were planned to undergo spermatic vein ligation under local anesthesia.
Methods: Thirty patient between the ages of 15-45 who were in the ASA I-II group were included in the study. They were randomly divided into 3 groups: continuous infusion (Group I), patient-controlled sedation (Group P) and control group (Group C). All patients were premedicated with 0.07 mg/kg midazolam intravenously (IV). 0.1 µg/kg/min remifentanil was given to Group I, 0.5 µg/kg bolus remifentanil was given to Group P, and physiological saline was given to Group C via a PCA (patient-controlled analgesia) device. The patients' hemodynamic parameters, sedation levels, anxiety scores, drug consumption amounts, patient satisfaction and side effects were recorded in the intraoperative and postoperative periods. During the operation, 2-3 L/min oxygen was administered via mask to patients whose SpO2 fell below 93%.
Results: Respiratory depression was more common in Group I but respiratory rate did not fall below 8 in any group. In Group I, 7 patient, in Group P, 4 patient required intraoperative oxygen. The total amount of drug consumed was 64.4 µg in Group P and 147.5 µg in Group I. Although the number of PCA requests was not different, 4 patients in Group I, 2 patients in Group P and 1 patient in Group C never pressed the device. In terms of patient satisfaction, 30% of the patients in Group I said it was excellent, while in Group C it was not evaluated as perfect. The number of patients who evaluated the method as excellent and very good was higher in Group P than Group I.
Conclusion: Remifentanil sedation with a PCA device can be used safely compared to infusion in patients undergoing spermatic vein ligation under local anesthesia.


1. Wang X, Pan C, Li J, et al. Prospective comparison of local anesthesiawith general or spinal anesthesia in patients treated with microscopicvaricocelectomy. J Clin Med. 2022;11(21):6397
2. Doğruer K, Köprülü AŞ, Karpat H. Summary book. A new perspectiveon sedation; anxiolysis, patient-controlled sedation. Intensive CareMed. 1996;42(2):89-90.
3. Mackenzie N, Grant IS. Propofol for intravenous sedation. Anaesthesia.1987;42(1):3-6. doi: 10.1111/j.1365-2044.1987.tb02936
4. Sutcliffe N. Sedation during loco-regional anaesthesia. ActaAnaesthesiol Belg. 2000;51(2):153-156.
5. Rêgo MM, Watcha MF, White PF. The changing role of monitoredanesthesia care in the ambulatory setting. Anesth Analg. 1997;85(5):1020-1036.
6. Avramov MN, Smith I, White PF. Interactions between midazolam andremifentanil during monitored anesthesia care. Anesthesiology. 1996;85(6):1283-1289. doi: 10.1097/00000542-199612000-00009
7. Nagengast FM. Sedation and monitoring in gastrointestinal endoscopy.Scand J Gastroenterol Suppl. 1993;200(1):28-32. doi: 10.3109/00365529309101572
8. Grattidge P. Patient-controlled sedation using propofol in day surgery.Anaesthesia. 1992;47(8):683-685.
9. Chumbley GM, Hall GM, Salmon P. Why do patients feel positive aboutpatient-controlled analgesia? Anaesthesia. 1999;54(4):386-389. doi: 10.1046/j.1365-2044.1999.00836.x
10. Folstein MF, Folstein SE, McHugh PR. Mini mental state. A practicalmethod for grading the cognitive state of patients for the clinician. JPsychiatr Res. 1975;12(3):189-198. doi: 10.1016/0022-3956(75)90026-6
11. Osborne GA, Rudkin GE, Jarvis DA, et al. Intra-operative patient-controlled sedation and patient attitude to control. A crossovercomparison of patient preference for patient-controlled propofol andpropofol by continuous infusion. Anaesthesia. 1994;49(4):287-292.
12. Fisher NC, Bailey S, Gibson JA. A prospective, randomized controlledtrial of sedation vs. no sedation in outpatient diagnostic uppergastrointestinal endoscopy. Endoscopy. 1998;30(1):21-24. doi: 10.1055/s-2007-993723
13. Bethune DW. Test of delayed memory recall suitable for assessingpostoperative amnesia. Anaesthesia. 1981;36(10):942-948. doi: 10.1111/j.1365-2044.1981.tb08652.x
14. Di Palo MT. Rating satisfaction research: is it poor, fair, good, verygood, or excellent? Arthritis Care Res. 1997;10(6):422-430. doi: 10.1002/art.1790100610. PMID: 9481234.
15. Galletly DC, Short TG, Forrest P. Patient administered anxiolysis-apilot study. Anaesth Intensive Care. 1989 May;17(2):144-50. doi: 10.1177/0310057X8901700204
16. Kerschbaum G, Altmeppen J, Funk W, Taeger K. Patient-controlledanalgesia. PCA in a three year old child after traumatic amputation.Anaesthesist. 1998;47(3):238-242.
17. Herrick IA, Gelb AW, Nichols B, Kirkby J. Patient-controlled propofolsedation for elderly patients: safety and patient attitude toward control.Can J Anaesth. 1996;43(10):1014-1018
18. Mazanikov M, Pöyhia R. Patient controlled sedation. Duodecim. 2011;127(9):883-889.
19. Rudkin GE, Osborne GA, Curtis NJ. Intra-operative patient-controlledsedation. Anaesthesia. 1991;46(2):90-92.
20. Güneş S, Türktan M, Güleç ÜK, Hatipoğlu Z, Ünlügenç H, Işık G.The comparison of patient-controlled remifentanil administered bytwo different protocols (bolus and bolus+infusion) and intramuscularmeperidine for labor analgesia. Turk J Anaesthesiol Reanim. 2014;42(5):264-269.
21. Mazanikov M, Udd M, Kylanpaa L, et al. Patient-controlled sedationwith propofol and remifentanil for ERCP: a randomized, controlledstudy. Gastrointest Endosc. 2011;73(2):260-266.
22. Veselis RA, Reinsel RA, Feshchenko VA, Wronski M. The comparativeamnestic effects of midazolam, propofol, thiopental, and fentanyl atequisedative concentrations. Anesthesiology. 1997;87(4):749-764. doi:10.1097/00000542-199710000-00007
23. Smith I, Avramov MN, White PF. A comparison of propofol andremifentanil during monitored anesthesia care. J Clin Anesth.1997;9(2):148-154. doi: 10.1016/S0952-8180(96)00240-1
24. Gold MI, Watkins WD, Sung YF, et al. Remifentanil versusremifentanil/midazolam for ambulatory surgery during monitoredanesthesia care. Anesthesiology. 1997;87(1):51-57.
25. White PF. Clinical uses of intravenous anesthetic and analgesicinfusions. Anesth Analg. 1989;68(2):161-171.
26. Medina HJ, Galvin EM, Dirckx M, et al. Remifentanil as a single drugfor extracorporeal shock wave lithotripsy: a comparison of infusiondoses in terms of analgesic potency and side effects. Anesth Analg.2005;101(2):365-370. doi: 10.1213/01.ANE.0000159379.54705.84
27. Puchner W, Egger P, Pühringer F, et al. Evaluation of remifentanil assingle drug for awake fiberoptic intubation. Acta Anaesthesiol Scand.2002;46(4):350-354. doi: 10.1034/j.1399-6576.2002.460403.x
28. Jones R, Pegrum A, Stacey RG. Patient-controlled analgesia usingremifentanil in the parturient with thrombocytopaenia. Anaesthesia.1999;54(5):461-465.
29. Sa Rego MM, Inagaki Y, White PF. Remifentanil administrationduring monitored anesthesia care: are intermittent boluses an effectivealternative to a continuous infusion? Anesth Analg. 1999;88(3):518-522.
30. Choi J, Choi H, Kang HS, Kang H. Comparison of alfentanil andremifentanil for the use of patient controlled sedation under localanesthesia during ear, nose and throat surgery. Korean J Anesthesiol.2009;56(5):507-512.
31. Joo JD, In JH, Kim DW, et al. The comparison of sedation quality, sideeffect and recovery profiles on different dosage of remifentanil patient-controlled sedation during breast biopsy surgery. Korean J Anesthesiol.2012;63(5):431-435.
32. Thorbiörnson A, Charvalho P, Gupta A, Stjernholm YV. Durationof labor, delivery mode and maternal and neonatal morbidity afterremifentanil patient-controlled analgesia compared with epiduralanalgesia. Eur J Obstet Gynecol Reprod Biol X. 2020;7(6):100106.
Volume 1, Issue 3, 2024
Page : 52-57
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