ORIGINAL ARTICLE
Year : 2012  |  Volume : 6  |  Issue : 3  |  Page : 268-272

Effect of fentanyl versus buprenorphine on the pupil size in phacoemulsification cataract surgery


1 Department of Anesthesiology, Bushehr University of Medical Sciences, Bushehr, Iran
2 Department of Ophthalmology, Bushehr University of Medical Sciences, Bushehr, Iran
3 Department of Community Medicine, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
4 Research Management, Research Deputy, Bushehr University of Medical Sciences, Bushehr, Iran

Correspondence Address:
Niloofar Motamed
Medical Faculty, Bushehr University of Medical Sciences, P.O. Box: 13185-1678, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.101220

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Background: Despite several recent innovations in phacoemulsification surgery, importance of pupil diameter in this surgery is becoming more evident. Purpose : To compare the effect of opioid agonist (fentanyl) versus opioid agonist-antagonist (buprenorphine) on pupil diameter in cataract surgery and to choose the best opioid in high-risk phacoemulsification surgery. Methods: In this randomized double-blinded clinical trial, 60 patients who were candidates for elective phacoemulsification surgery were randomly divided into two equal groups: experimental (buprenorphine, 0.3 μg/kg) and control (fentanyl, 1 μg/kg). Pupil diameter was measured preinjection and at several times postinjection. Blood pressure was recorded at several intervals, as well as shivering, nausea and vomiting, and recovery time. Results: Mean (SD) recovery time was significantly less in the control group (19.46±5.43) than in the experimental group (33.23±10.75) (P<0.0001). The constriction effect (ie, pupillary diameter in mm) was significantly lower in the experimental group (0.53±0.45) than in the control group (1.06±0.52) (P=0.0001). The percentages of constriction effect in experimentaland control groups were 7.68% and 15.07%, respectively. The eye was two times more constricted in the control group in comparison with the experimental group after induction of anesthesia. Conclusion: Buprenorphine is a better solution to decrease pupil constriction in comparison with fentanylinhigh-risk phacoemulsification surgery.


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