RESUMEN
BACKGROUND AND OBJECTIVES: Patients undergoing eye surgery under regional anaesthesia often require concomitant medication for analgesia and comfort. Remifentanil, with its ultra-short acting-profile, may be useful to reduce pain during retrobulbar nerve block for cataract surgery. METHODS: We performed a prospective, randomized, double-blind study to compare the efficacy of remifentanil for analgesia during retrobulbar nerve block placement. Ninety patients undergoing cataract surgery were randomly divided to receive either remifentanil 0.3 microg kg(-1) (n = 45) or an equivalent volume of saline (n = 45). The injection was administered within 30 s in both groups. Patients rated their amount of pain on a 10 cm visual analogue scale. Respiratory frequency, oxygen saturation, cardiac rhythm and postoperative nausea and vomiting (PONV) were recorded. RESULTS: The mean visual analogue score in the Remifentanil group was 2.56; it was 5.51 in the Saline group (P = 0.001, U-test). Three patients developed bradycardia and three had PONV in the Remifentanil group. Two patients developed tachycardia and one had PONV in the Saline group. No patient developed respiratory depression. CONCLUSION: In patients undergoing retrobulbar block placement for eye surgery, 0.3 microg kg(-1) remifentanil over 30 s significantly reduced their reported pain. In addition, remifentanil did not increase the risk of untoward side-effects.
Asunto(s)
Analgésicos Opioides/uso terapéutico , Extracción de Catarata , Bloqueo Nervioso/efectos adversos , Dolor/etiología , Dolor/prevención & control , Piperidinas/uso terapéutico , Anciano , Analgésicos Opioides/efectos adversos , Método Doble Ciego , Femenino , Hemodinámica , Humanos , Masculino , Monitoreo Intraoperatorio , Dimensión del Dolor , Piperidinas/efectos adversos , Náusea y Vómito Posoperatorios/epidemiología , Estudios Prospectivos , RemifentaniloRESUMEN
The circadian rhythm of melatonin secretion was measured in 20 healthy males (20 - 32 yrs.) after intake of placebo or various doses of a special extract of Agnus castus (AC: 120 - 480 mg/die) for 14 days. A significant (p < 0.05) dose-dependent increase of the area under the melatonin secretion curve (AUC) was found. The pattern of circadian rhythm of melatonin secretion was, however, not influenced. It remains to be elucidated whether the AC-stimulated increase of melatonin secretion is suitable for treatment of sleep disturbances.