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
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.