ANALGESIA FOR RETROBULBAR BLOCK - Comparison of Remifentanil, Alfentanil and Fentanyl -

Background: The injection of retrobulbar block is associated with significant pain and discomfort. Therefore a short-acting IV analgesic before retrobulbar injection has been advocated. Objective: To compare remifentanil, alfentanil and fentanyl in providing analgesia for retrobulbar block injection. Methods: 69 patients were enrolled randomly into three groups of 23 each to receive either Remifentanil 1 µg/kg, Alfentanil 20 µg/kg or Fentanyl 2 µg/kg as an IV bolus dose prior to retrobulbar injection. Mean arterial pressure (MAP) and heart rate (HR) were recorded and Numerical Pain Score (NPS) were assessed by a blinded observer. Results: Remifentanil prevented increase in MAP and HR while alfentanil and fentanyl were ineffective in this purpose (p 0.05). NPS was significantly lower in remifentanil group (p 0.05). Conclusion: Remifentanil 1 µg/kg prior to retrobulbar injection provide excellent hemodynamic stability and ensure analgesia.