| Remifentanil for general anaesthesia: a systematic review. | |
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MedLine Citation:
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PMID: 17991265 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We performed a quantitative systematic review of randomised, controlled trials that compared remifentanil to short-acting opioids (fentanyl, alfentanil, or sufentanil) for general anaesthesia. Eighty-five trials were identified and these included a total of 13 057 patients. Intra-operatively, remifentanil was associated with clinical signs of deeper analgesia and anaesthesia, such as fewer responses to noxious stimuli (relative risk 0.65, 95% CI 0.48-0.87), more frequent episodes of bradycardia (1.46, 1.04-2.05), more hypotension (1.68, 1.36-2.07) and less hypertension (0.60, 0.46-0.78). Postoperatively, remifentanil was associated with faster recovery (difference in extubation time of -2.03, 9.5% CI, -2.92 to -1.14 min), more frequent postoperative analgesic requirements (1.36, 1.21-1.53) and fewer respiratory events requiring naloxone (0.25, 0.14-0.47). Remifentanil had no overall impact on postoperative nausea (1.03, 0.97-1.09) or vomiting (1.06, 0.96-1.17), but was associated with twice as much shivering (2.15, 1.73-2.69). Remifentanil does not seem to offer any advantage for lengthy, major interventions, but may be useful for selected patients, e.g. when postoperative respiratory depression is a concern. |
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Authors:
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R Komatsu; A M Turan; M Orhan-Sungur; J McGuire; O C Radke; C C Apfel |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Anaesthesia Volume: 62 ISSN: 1365-2044 ISO Abbreviation: Anaesthesia Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-09 Completed Date: 2007-12-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370524 Medline TA: Anaesthesia Country: England |
Other Details:
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Languages: eng Pagination: 1266-80 Citation Subset: AIM; IM |
Affiliation:
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Department of Anaesthesiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjukuku, Tokyo 162-8666, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analgesics, Opioid*
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adverse effects Anesthesia Recovery Period Anesthesia, General / methods* Evidence-Based Medicine Humans Intraoperative Complications / chemically induced Piperidines* / adverse effects Postoperative Complications / chemically induced Randomized Controlled Trials as Topic |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 0/Piperidines; 132875-61-7/remifentanil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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