• Osman N Aydin, Bakiye Ugur, Erkin Kir, and Seyhan B Ozkan.
• Department of Anesthesiology and Reanimation, Adnan Menderes University, Faculty of Medicine, Aydin, Turkey. onaydin@superonline.com
• J Clin Anesth. 2004 Mar 1;16(2):98-103.

Study ObjectivesTo evaluate the effects of fentanyl on the cardiorespiratory system in elderly patients undergoing cataract surgery with phacoemulsification method.DesignRandomized, prospective, double-blind study.SettingUniversity hospital.Patients70 ASA physical status I, II, and III patients (>60 years) who underwent cataract surgery with topical anesthesia.InterventionsPatients were randomly divided into two groups. The fentanyl group (35 patients) received fentanyl in 0.7 microg/kg bolus doses in a 2-mL balanced salt solution prior to surgery. The control group (35 patients) received a 2-mL balanced salt solution without any analgesic drug.Measurements And Main ResultsSystolic (SBP), diastolic (DBP), mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (SpO(2)), respiratory rate (RR), end-tidal carbon dioxide (ETCO(2)), inspired CO(2) concentration, and sedation scores were measured preoperatively and at 5, 10, 15, 20, and 30 minutes intraoperatively. Postoperatively, patients were questioned about the presence of intraoperative pain. In the fentanyl group, no significant differences were observed in SPB, DBP, MAP, RR, or peripheral SpO(2). In the control group, RR was higher than baseline values at 10, 15, and 20 minutes. Diastolic blood pressure was higher than baseline values at 20 minutes. End-tidal CO(2) and inspired CO(2) levels were higher than baseline levels in both groups at all measurement times. Intraoperative ETCO(2) levels were higher in the fentanyl group than the control group (p < 0.01). Finally, no hypoxemia was observed in either group.ConclusionFentanyl can be used safely in 0.7-microg/kg dosages in elderly patients to improve patient comfort without any cardiorespiratory side effects, when undergoing cataract surgery with topical anesthesia.

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