The effect of sublingual fentanyl in comparison with intravenous ketamine onpain control and hemodynamic parameters during and after cataract surgeryby phacoemulsification method

Background: The aim of this study was to evaluate the effect of sublingual fentanyl in comparison withintravenous ketamine on pain control and hemodynamic parameters during and after cataract surgery byphacoemulsification under local sedation and anesthesia.Methods: In this double-blind randomized clinical trial study, ۹۰ patients who were candidates for cataractsurgery were divided into two groups of ۴۵ patients. In the first group, fentanyl was administered sublingually ata dose of ۱.۵ μg/kg up to ۱۰۰ μg and in the second group ketamine was injected intravenously with a dose of۰.۳ mg/kg, followed by IV propofol titrated to desired sedation. The quality of sedation and hemodynamicparameters, patient and surgeon satisfaction, and complications during and after surgery were determined andcompared in the two groups.Findings: The mean intraoperative Ramsay sedation score wasn't statistically different between the two groupsof Ketamine and Fentanyl (P = ۰.۰۸۳). During the operation, the dose of propofol in the fentanyl group wassignificantly higher than that of ketamine (P = ۰.۰۳۶). The frequency of pain in recovery was significantly higherin the fentanyl group (p = ۰.۰۰۱). Changes in hemodynamic parameters during surgery and recovery were notsignificantly different between the two groups (P <۰.۰۵). Patient satisfaction (P = ۰.۶۱) and surgeon (P = ۰.۱۵)were not significantly different between fentanyl and ketamine.Conclusion: According to the findings of the present study, it seems that the use of low dose intravenousketamine has a more favorable effect than sublingual fentanyl on the management and control of sedationduring cataract surgery and requires less rescue dose of propofol than sublingual fentanyl.

کلیدواژه ها:

Cataract ، ketamine ، fentanyl ، Propofol ، sublingual