Razi Journal of Medical Sciences

    Background & Aim: Paracetamol is a non-opioid and non-NSAID(non non-steroidal anti-inflammatory drug) analgesic with central function. Analgesic effect of paracetamol is similar to opioids and NSAIDs but different from them in terms of side effects. Remifentanil is a short-acting opioid. In our study, we assess the effect of these two drugs on the depth of anesthesia using BIS monitoring. BIS(Bispectral) index is a complex EEG(Electroencephalograph) parameter. Bispectral index values of 0 represent an isoelectric EEG, where values of 100 represent awareness. Patients & Method: This study was done on 100 ASA-1(American Society of Anesthesiologists) patients who were candidates for endoscopic sinus surgery. Patients who were out of the age range of 15-45 years were excluded. Then the patients were randomly divided into two groups of 50. The first group included patients using paracetamol and the other group used remifentanil. Both groups received 1μg/kg of fentanil as premedication. Induction of anesthesia in the first group was started by using propofol 2.5mg/kg and then cysatracurium 0.15mg/kg. Propofol 100μg/kg/min+N2O 50%,O2 50%(equal minute volume)+paracetamol 1gr/Q4h were administered for maintenance. In the other group the induction was similar to the first group, but for maintenance propofol 100μg/kg/min+N2O 50%, O2 50%(equal minute volume)+remifentanil 1μg/kg/min were administered. For each group, depth of anesthesia was measured during laryngoscopy, intubation and incision. Blood pressure and heart rate were recorded on collecting data sheets too. Results: Data was analyzed using independent sample t-test and PV<0.05 was statistically significant. The analysis of data showed no significant difference between the two groups(PV>0.05). As a result, there is no difference between the effect of paracetamol and remifentanil on the depth of anesthesia. Conclusion: These findings suggest that infusion of paracetamol replace remifentanil in order to observe hemodynamic stability during the surgery.