Postoperative analgesic effects of preoperative intravenous apotel and remifentanil in septorhinoplasty: a randomized, doubleblind clinical trial

OBJECTIVE: To compare the postoperative induced hypotension anesthesia, complications and analgesic effects of intravenous Apotel and Remifentanil in adult patients undergoing Septorhinoplasty.METHODS: A randomized clinical trial was performed in Ordibehesht hospital during a 1-year period. We included 60 patients with ASA I and II status scheduled for Septorhinoplasty who were randomly assigned to receive Remifentanil (n=30) or intravenous Apotel (n=30) before induction of the anesthesia. The anesthesia and surgery protocol was similar between the two study groups. The intraoperative blood pressure, postoperative pain based on VAS scale, postoperative nausea and vomiting, shivering and agitation were recorded and further compared between the two study groups. The amount of rescue analgesic was also compared.RESULTS: There was no significant difference between the two study groups regarding the baseline characteristics. The systolic and diastolic blood pressure was not significantly different between the two study groups in any of the anesthesia induction. We found that the incidence of postoperative shivering (p=0.011) and pain (p=0.041) was significantly lower in those who received Apotel. The VAS score was also significantly lower in the Apotel in comparison to Remifentanil group at 1 (p=0.035), 2 (p=0.026) and 4 (p=0.028) hours after the operation. The need for rescue analgesic was also significantly lower in the Apotel when compared to Remifentanil group (p=0.001).CONCLUSIONS: Intravenous Apotel is a safe and effective agent as premedication in those undergoing Septorhinoplasty. It is associated with hemodynamic stability during the operation and decreased postoperative pain and shivering when compared to Remifentanil. Thus it could be recommended for this purpose