Remifentanil infusion versus propofol and remifentanil patient controlled sedation/analgesia for moderate sedation during interventional radiological procedures: A prospective randomized trial

Abstract

The use of intravenous sedation and analgesia during interventional radiological procedures is increasing. Sedation and analgesia should minimize patients' negative psychological reactions caused by fears and anxiety. Also they should relieve pain and provide patients a safe and comfortable environment. The aim of this study was to compare the efficacy and safety of two drugs and methods used for moderate sedation during radiological procedures. Material and Methods: Sixty patients, with American Society of Anesthesiologists scores (ASA) I-II-III, undergoing interventional radiology procedures were included in this study. The patients were administered remifentanil bolus (0.2 µg.kg-1) followed by remifentanil infusion (0.05 µg.kg-1.min-1) in Group R, 2.5mL loading dose (25 mg propofol-25 µg remifentanil) and a 1mL bolus dose (10 mg propofol-10 µg remifentanil) via patient-controlled analgesia/sedation (PCAS) device in Group PR. All the patients' sedation levels were assessed with the Ramsey Sedation Scale (RSS), pain levels were assessed with Visual Analog Scale (VAS). Their recoveries were assessed with the modified Aldrete score (MAS) at 5 min intervals. Results: Although a significant difference was noted between the groups for RSS values at 5, 10, 20, 25, and 30th minutes during the procedure (P<0.05), there was no significant difference in VAS, anxiety levels and MAS (P > 0.05). Conclusion: Both propofol-remifentanil PCAS and remifentanil infusion provide sufficient moderate sedation.