Comparison of the use of remifentanil in infusion and patient-controlled methods for sedation purposes

Aims: In this study, the infusion and patient-controlled with PCA device use of remifentanil used for sedation were compared in patients who were planned to undergo spermatic vein ligation under local anesthesia. Methods: Thirty patient between the ages of 15-45 who were in the ASA I-II group were included in the study. They were randomly divided into 3 groups: continuous infusion (Group I), patient-controlled sedation (Group P) and control group (Group C). All patients were premedicated with 0.07 mg/kg midazolam intravenously (IV). 0.1 µg/kg/min remifentanil was given to Group I, 0.5 µg/kg bolus remifentanil was given to Group P, and physiological saline was given to Group C via a PCA (patient-controlled analgesia) device. The patients' hemodynamic parameters, sedation levels, anxiety scores, drug consumption amounts, patient satisfaction and side effects were recorded in the intraoperative and postoperative periods. During the operation, 2-3 L/min oxygen was administered via mask to patients whose SpO2 fell below 93%. Results: Respiratory depression was more common in Group I but respiratory rate did not fall below 8 in any group. In Group I, 7 patient, in Group P, 4 patient required intraoperative oxygen. The total amount of drug consumed was 64.4 µg in Group P and 147.5 µg in Group I. Although the number of PCA requests was not different, 4 patients in Group I, 2 patients in Group P and 1 patient in Group C never pressed the device. In terms of patient satisfaction, 30% of the patients in Group I said it was excellent, while in Group C it was not evaluated as perfect. The number of patients who evaluated the method as excellent and very good was higher in Group P than Group I. Conclusion: Remifentanil sedation with a PCA device can be used safely compared to infusion in patients undergoing spermatic vein ligation under local anesthesia.