The Effects of Propofol-Remifentanil Vs Midazolam-Remifentanil on Hemodynamic Stability during Stapedectomy: A Randomized Clinical Trial

Background: One of the essential components during stapedectomy is a good cooperation between patient and surgeon. Remifentanil is commonly used short – acting opioid to assess the results during the procedure. Purpose: The aim of this study is to investigate the effects of propofol- remifentanil and midazolam -remifentanil on hemodynamic parameters intra- Stapedectomy. Methods: In this randomized, double-blinded trial, 36 patients with otosclerosis were evaluated in two equal groups, which received propofol- remifentanil and midazolam- remifentanil each. We recorded cardio-respiratory parameters, side effects and intra-operative cooperation of the patients. Results: There was a statistically significant difference in blood pressure reduction between two groups. The severity of the bleeding and desirable cooperation of patients in midazolam- based regimen was better than propofol- based regimen (p- value= 0.01 and 0.02 respectively). The average operative time in patients who received propofol was about 15 minutes more than the other group (p- value=0.01). Conclusion: The midazolam - remifentanil is more appropriate sedative, because it provides hemodynamic stability and a better cooperation of patient intra - stapedectomy.