Quality of sedation with remifentanil versus propofol for peribulbar block in elective ophthalmologic procedures.

Abstract

General objective: to evaluate the quality of sedation with remifentanil and propofol in patients undergoing peribulbar block for elective ophthalmic surgeries at the La Trinidad Teaching Medical Center, Caracas, Venezuela, during the period May–October 2025. Materials and methods: a randomized, double-blind, comparative clinical trial was conducted with 50 adult ASA I-II-III patients divided into two groups: remifentanil (n=25) and propofol (n=25). Both groups received midazolam as premedication and were monitored with blood pressure, heart rate, respiratory rate, and oxygen saturation. Sedation was assessed using the Ramsay Scale, pain with the Numerical Rating Scale (NRS), and recovery with standardized clinical parameters. Likert-type surveys were used to assess patient and anesthesiologist satisfaction. Statistical analysis was performed using SPSS v25, employing Mann-Whitney U tests, with a significance level of p<0.05. Results: propofol demonstrated greater depth of sedation (Ramsay 3.96 vs. 2.64; p=0.000) and greater patient satisfaction (100% very satisfied vs. 84%; p=0.039). Both groups experienced complete recovery without serious adverse events or the need for medical interventions. Anesthesiologist satisfaction was high for both regimens. Conclusion: both remifentanil and propofol are safe and effective for sedation in peribulbar block. Propofol offers greater patient comfort and is more readily accepted by professionals, while remifentanil provides the advantage of more conscious sedation. These results support the standardization of sedation protocols in outpatient ophthalmology.