Sedative-Analgesic Activity of Remifentanil and Effects of Preoperative Anxiety on Perceived Pain in Outpatient Mandibular Third Molar Surgery

Abstract

The aim of this study was to assess the sedative-analgesic activity of different doses of remifentanil and effects of preoperative anxiety on intraoperative pain levels in patients attending a dental clinic. The patients (n = 60) were divided into two groups according to the remifentanil infusion dose given: group R<inf>1</inf>: 0.05 μg/kg/min; group R<inf>2</inf>: 0.1 μg/kg/min. The following were evaluated: haemodynamic parameters, State-Trait Anxiety Inventory (STAI) TX-I score, pain level due to local anaesthesia injection, time to reach a Ramsay Sedation Scale (RSS) score of 3, amount of bolus dose, total drug consumption, recovery period, patient and surgeon satisfaction, and complications. The patient satisfaction score on a visual analogue scale (VAS) was 90 in group R<inf>1</inf> and 100 in group R<inf>2</inf> (P = 0.008); the surgeon satisfaction score was 80 in group R<inf>1</inf> and 90 in group R<inf>2</inf> (P = 0.004). The time to reach an RSS score of 3 and the amount of bolus dose were significantly lower in group R<inf>2</inf> than in group R<inf>1</inf>. High levels of anxiety did not affect intraoperative pain levels. In conclusion, high doses of remifentanil can safely be used for various same-day dental surgery interventions. © 2016 International Association of Oral and Maxillofacial Surgeons