Efficacy and Safety of intranasal fentanyl vs intranasal ketamine in cataractsurgery

Background: Cataract surgery require relaxation and immobility of patients. This study aimed to compare theeffect of intranasal fentanyl vs intranasal ketamine on the quality of sedation and analgesia in cataractsurgery.Methods: This randomized, double-blinded clinical trial study was conducted in Faiz hospital, Isfahan, Iranduring ۲۰۱۸-۱۹. Eighty patients were randomly divided into two groups receiving ketamine ۱.۵ mg/kg (INKgroup) or fentanyl ۱.۵ μg/kg (INF group). The medications were instilled intranasal ۱۵ minutes before initiatingthe procedure. The primary outcomes were a difference in the quality of sedation and pain relief betweengroups during the procedure and recovery unit. Secondary outcomes were side effects, the need for sedativerescues, and changes in vital signs.Results: The mean hemodynamic parameters were not significantly different between the two groups at eachtime (P value>۰.۰۵). In the INK group ۲۵ patients (۶۲.۵%) and INF group ۱۹ patients (۴۷.۵%) had no pain. Inthe INK group, ۲۲ (۵۵%) and in the INF group, ۲۰ (۵۰.۰%) achieved reached Ramsey Score ۴. There was nosignificant difference between the groups in the vital signs or in the change of the vital signs at each time.Conclusion: Intranasal ketamine was more effective in relieving pain, and on the other hand, intranasalfentanyl had a better sedative quality than ketamine, but neither had a significant superiority over the other.Intranasal administration of fentanyl and ketamine is safe and effective in cataract surgery.