Introduction: Today, Phacoemulsification surgery is mostly carried out under local or areal anesthesia. In this anesthesia the patient needs to be sedated. Furthermore, because intracameral injection is painful an Intra-Venus (IV) analgesia is also required that bolus dose of Fentanyl and Remifentanyl are used. In this study effect of Remifentanyl and Fentanyl are compared.

Material and methods: This Clinical Trial study was carried out on 64 patients with cataract who underwent phacoemulsification surgery in Baqiyatallah hospital in second half of year 1390. Patients with ASA class I & II were chosen and randomly divided into two groups. Vital signs, rates of pain, sedation according to Ramsy Score(RS), surgeon and patients satisfaction recorded in both groups using questionnaire. SPSS ver.18 was used to analyze data.

Results: thirty six patients were in Fentanyl group (average age= 64.71±8.21 y/o) and 28 in Remifentanyl group (average age= 65.2±12.43). RS in Fentanyl group was significantly Higher in Remifentanyl group (2.02±1.08 v/s 1.42±1.19, p<.05). Rate of satisfaction of patients and surgeons was significantly higher in Fentanyl group in comparison with Remifentanyl (p<.05). Side effects in Fentanyl group was also significantly less than Remifentanyl (p<.05). There was no significant difference in vital signs of patients in two groups neither before surgery nor after that.

Conclusion: Results of this study show that, Fentanyl has less side effects, more sedation effect and more patient and surgeon satisfaction in comparison with Remifentanyl and we recommend it as an analgesic with local anesthesia in cataract surgery.