Comparing the effects of remifentanil with fentanyl on pain intensity, hemodynamic status and post-anesthesia complications of cataract surgery candidates

Introduction: Opioids such as fentanyl and remifentanil are commonly used for anesthesia induction and maintenance, each with distinct pharmacokinetic and pharmacodynamic properties. This study aimed to compare their effects on hemodynamic stability, intraoperative excitability, neuromuscular blockade requirement, postoperative nausea, and recovery characteristics.Materials and Methods: This prospective, randomized clinical trial included ۴۰۰ patients, equally divided into fentanyl (n=۲۰۰) and remifentanil (n=۲۰۰) groups. Baseline characteristics, intraoperative hemodynamics, anesthesia recovery parameters, and postoperative complications were recorded. Data were analyzed using appropriate statistical tests, with P < ۰.۰۵ considered statistically significant.Results: The remifentanil group exhibited significantly lower heart rate and blood pressure at all measured time points post-induction (P < ۰.۰۵). Intraoperative excitability and neuromuscular blocker requirement were higher in the remifentanil group (P = ۰.۰۱۴, P = ۰.۰۰۹). Postoperative nausea and antiemetic use were significantly higher in the fentanyl group (P = ۰.۰۴۱, P = ۰.۰۳۸). The remifentanil group had faster induction, earlier respiratory recovery, and shorter awakening time (P < ۰.۰۵).Conclusion: Remifentanil ensures faster recovery with reduced postoperative nausea but causes greater hemodynamic suppression and intraoperative excitability. These findings support tailored opioid selection based on surgical needs and patient-specific factors.

کلیدواژه ها:

Fentanyl ، Remifentanil ، Hemodynamic Stability ، Anesthesia Recovery