Key result
Remifentanil-based fast-track anesthesia significantly reduced mechanical ventilation duration, ICU and hospital stay, and expenses compared to fentanyl-based routine anesthesia (P<0.05).
Why the study?
The study aimed to evaluate the effectiveness and safety of remifentanil-based fast-track anesthesia for intraoperative device closure of atrial septal defects.
Does remifentanil-based fast-track anesthesia improve postoperative outcomes and reduce resource utilization compared to fentanyl-based routine anesthesia in pediatric patients undergoing intraoperative device closure of ASD?
Cohort (n=152)
No
Does remifentanil-based fast-track anesthesia improve postoperative outcomes and reduce resource utilization compared to fentanyl-based routine anesthesia in pediatric patients undergoing intraoperative device closure of ASD?
p-value: p=<0.05
Remifentanil-based fast-track anesthesia is a safe and effective alternative to routine fentanyl-based anesthesia for pediatric ASD closure, offering reduced mechanical ventilation time, shorter hospital stays, and lower costs.
Remifentanil fast-track anesthesia was associated with shorter recovery in pediatric ASD closure; leaves open confirmation by randomized trials.
BACKGROUND The aim of this study was to evaluate the effectiveness and safety of remifentanil-based fast-track anesthesia for intraoperative device closure of atrial septal defects (ASDs). MATERIAL AND METHODS The clinical data of 152 pediatric patients who received intraoperative device closure of ASD in our hospital from January 2015 to December 2017 were retrospectively analyzed. Patients were divided into 2 groups: group F (remifentanil-based fast-track anesthesia group, n=72) and group C (fentanyl-based routine anesthesia group, n=80). The relevant data from 2 groups were collected and analyzed. RESULTS No significant differences were found in the preoperative data or intraoperative hemodynamic index between these 2 groups. Group C was significantly inferior to group F regarding the duration of mechanical ventilation, length of intensive care unit (ICU) stay, length of hospital stay, and hospitalization expenses (P<0.05). In terms of postoperative complications, no death, third-degree atrioventricular block, occluder detachment, or residual leakage was reported in either group. The incidence of lung infections and bronchospasm was significantly higher in group C than in group F. There were no anesthetic-related complications. CONCLUSIONS The application of remifentanil-based fast-track anesthesia for intraoperative device closure of ASD is as effective and safe as fentanyl-based routine anesthesia. Moreover, remifentanil-based fast-track anesthesia has the advantages of shorter duration of mechanical ventilation, shorter length of hospital and ICU stay, fewer postoperative complications, and lower hospitalization expenses, and is therefore worthy of promotion in clinical practice.
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Huang et al. (2019) conducted a cohort in Atrial septal defects (ASDs) (n=152). Remifentanil-based fast-track anesthesia vs. Fentanyl-based routine anesthesia was evaluated on Duration of mechanical ventilation, length of ICU stay, length of hospital stay, and hospitalization expenses (p=<0.05). Remifentanil-based fast-track anesthesia significantly reduced mechanical ventilation duration, ICU and hospital stay, and expenses compared to fentanyl-based routine anesthesia (P<0.05).
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