Key result
Remifentanil and sufentanil provided similar intra- and postoperative hemodynamic stability during carotid endarterectomy, but remifentanil more effectively blunted SBP increases at intubation (P<0.05).
Why the study?
Does remifentanil improve hemodynamic stability compared to sufentanil in patients undergoing carotid endarterectomy?
RCT (n=56)
Randomized
Does remifentanil improve hemodynamic stability compared to sufentanil in patients undergoing carotid endarterectomy?
p-value: p=<0.05
Remifentanil and sufentanil provide similar intra- and postoperative hemodynamic stability during carotid endarterectomy, though remifentanil better blunts systolic blood pressure increases at intubation.
Remifentanil may be favored for intubation blunting in carotid endarterectomy; extends RCT data on opioid selection for hemodynamic control.
UNLABELLED: We compared the hemodynamic stability during carotid endarterectomy of remifentanil with that of sufentanil anesthesia. Fifty-six patients were randomly assigned into Remifentanil (n = 27) or Sufentanil (n = 29) groups. In the Remifentanil group, IV propacetamol (2 g) and morphine (0.1 mg/kg) were infused 30 min before skin closure. In the Sufentanil group, patients received 2 g propacetamol. Beat-to-beat recordings of systolic arterial blood pressure (SBP) and heart rate (HR) were stored on a computer. The maximum and minimum values of BP and HR after induction, at intubation, during the surgical procedure, and after the operation and the coefficients of variation of SBP and HR were used as indices of hemodynamic stability. The coefficients of variation of SBP and HR were similar in both groups during and after surgery. However, at intubation, maximal SBP was higher in the Sufentanil group (P < 0.05). Decreased propofol doses and isoflurane end-tidal concentrations were used in the Remifentanil group. At recovery, a similar profile of SBP and HR was found in both groups. We conclude that intra- and posthemodynamic stability was similar with remifentanil or sufentanil in patients undergoing carotid endarterectomy. However, remifentanil was more effective for blunting the increase in SBP at intubation without increasing the blood pressure-decreasing effect of induction. Intraoperative remifentanil use was associated with a decreased amount of hypnotic drug administered. IMPLICATIONS: Beat-to-beat recordings of heart rate and blood pressure in patients undergoing carotid surgery revealed that hemodynamic stability was similar with remifentanil or sufentanil anesthesia both during and after surgery. Remifentanil was more effective in limiting the increase in blood pressure associated with intubation without increasing the blood pressure-lowering effect of induction or the blood pressure response to recovery.
No takes yet. Share an insight, caveat, or question.
Mouren et al. (2001) conducted an RCT in Patients undergoing carotid endarterectomy (n=56). Remifentanil vs. Sufentanil (with 2 g propacetamol) was evaluated on Hemodynamic stability (coefficients of variation of SBP and HR, maximum and minimum values of BP and HR) (p=<0.05). Remifentanil and sufentanil provided similar intra- and postoperative hemodynamic stability during carotid endarterectomy, but remifentanil more effectively blunted SBP increases at intubation (P<0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: