Comparative efficacy and safety of remifentanil and fentanyl in 'fast track' coronary artery bypass graft surgery: a randomized, double-blind study

Citation
T. Mollhoff et al., Comparative efficacy and safety of remifentanil and fentanyl in 'fast track' coronary artery bypass graft surgery: a randomized, double-blind study, BR J ANAEST, 87(5), 2001, pp. 718-726
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
BRITISH JOURNAL OF ANAESTHESIA
ISSN journal
0007-0912 → ACNP
Volume
87
Issue
5
Year of publication
2001
Pages
718 - 726
Database
ISI
SICI code
0007-0912(200111)87:5<718:CEASOR>2.0.ZU;2-A
Abstract
This: multi-centre, parallel group, randomized, double-blind study compared the efficacy and safety of high-dose remifentanil administered by continuo us infusion with an intermittent bolus fentanyl regimen, when given in comb ination with propofol for general anaesthesia in 321 patients undergoing el ective coronary artery bypass graft surgery. A significantly lower proporti on of the patients who received remifentanil had responses to maximal stern al spread (the primary efficacy endpoint) compared with those who received fentanyl (11% vs 52%; P<0.001). More patients who received remifentanil res ponded to tracheal intubation compared with those who received fentanyl (24 % vs 9%; P<0.001). However, fewer patients who received remifentanil respon ded to sternal skin incision (11% vs 36%; P<0.001) and sternotomy (14% vs 6 0%; P<0.001). Median time to extubation was longer in the subjects who rece ived remifentanil than for those who received fentanyl (5.1 vs 4.2 h; P=0.0 06). There were no statistically significant differences between the two gr oups in the times for transfer from intensive care unit or hospital dischar ge but time to extubation was significantly longer in the remifentanil grou p. Overall, the incidence of adverse events was similar but greater in the remifentanil group with respect to shivering (P<0.049) and hypertension (P< 0.001). Significantly more drug-related adverse events were reported in the remifentanil group (P=0.016) There were no drug-related adverse cardiac ou tcomes and no deaths from cardiac causes before hospital discharge in eithe r treatment group.