Comparision of remifentanil and remifentanil/midazolam for outpatient anesthesia in prolotherapy.

Lee,  Hyung Suk; Jo,  Dae Hyun; Kim,  Min Gu; Kim,  Myung Hee; Park,  Sa Hyun; Chung,  Sung Hee

doi:2009.56.2.175

Original Article

Korean Journal of Anesthesiology 2009;56(2):175-180.
DOI: https://doi.org/10.4097/kjae.2009.56.2.175

Comparision of remifentanil and remifentanil/midazolam for outpatient anesthesia in prolotherapy.

Hyung Suk Lee, Dae Hyun Jo, Min Gu Kim, Myung Hee Kim, Sa Hyun Park, Sung Hee Chung

¹Department of Anesthesiology and Pain Medicine, The Armed Forces Daejun Hospital, Daejeon, Korea.
²Pain Clinic, College of Medicine, Pochon CHA University, Bundang CHA Hospital, Seongnam, Korea. pandjo@mdhouse.com
³Department of Anesthesiology and Pain Medicine, College of Medicine, Pochon CHA University, Bundang CHA Hospital, Seongnam, Korea.

Abstract

BACKGROUND
Prolotherapy is a therapeutic procedure used for chronic musculoskeletal and arthritic pain. It involves injecting an irritant solution to pain sites and causes patient discomfort, which can lead to treatment discontinuation. Remifentanil is an ultra short-acting micro-opiate receptor agonist that permits a rapid transition from intense analgesia to a minimal residual effect. Here, we evaluated the effect of remifentanil as a preparative medication for ambulatory prolotherapy.
METHODS
Eighty patients taking prolotherapy were assigned into three groups for pre-therapeutic injections: remifentanil 0.1 microgram/kg/min alone (Group R), remifentanil 0.05 microgram/kg/min with midazolam 2 mg (Group M), and normal saline (Group C). Pain and sedation scores, blood pressure, pulse oxygen saturation, heart rate, satisfaction score, and time to discharge were measured.
RESULTS
Pain scores in groups M and R were lower than group C during and after prolotherapy. The sedation score of group M was higher than groups R and C. Nine patients in group R experienced dizziness during prolotherapy. In group M, 8 patients experienced dizziness and 2 patients experienced nausea. There was no difference in time to discharge among all groups. Satisfaction scores in group M (7.3 +/- 0.8) and group R (7.0 +/- 0.8) were higher than that of group C (5.3 +/- 0.6).
CONCLUSIONS
Remifentanil and remifentanil/midazolam effectively reduce the pain produced by prolotherapy.

Key Words: Midazolam; Outpatient; Pain; Prolotherapy; Remifentanil; Sedation