Document Detail


Remifentanil for general anaesthesia: a systematic review.
MedLine Citation:
PMID:  17991265     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R Komatsu; A M Turan; M Orhan-Sungur; J McGuire; O C Radke; C C Apfel
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Anaesthesia     Volume:  62     ISSN:  1365-2044     ISO Abbreviation:  Anaesthesia     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-09     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  1266-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Anaesthesiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjukuku, Tokyo 162-8666, Japan.
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid* / 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:
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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