Key result
Remifentanil was associated with lower pain scores in the first postoperative hour and lower morphine requirements after 24 hours compared to morphine-metamizole following cardiac surgery.
Why the study?
Pain management after cardiac surgery traditionally relied on parenteral long-acting opioids such as morphine, and the efficacy of remifentanil versus morphine-metamizole for post-cardiac surgery pain relief needed comparison.
Does remifentanil improve postoperative pain relief and reduce morphine requirements in patients undergoing on-pump coronary artery bypass surgery compared to morphine-metamizole?
Does remifentanil improve postoperative pain relief and reduce morphine requirements in patients undergoing on-pump coronary artery bypass surgery compared to morphine-metamizole?
Absolute Event Rate: 2% vs 6%
The use of remifentanil for postoperative analgesia following CABG is associated with lower early pain scores and reduced 24-hour morphine requirements compared to fentanyl-based anesthesia followed by immediate morphine-metamizole.
Small pilot leaves post-cardiac surgery analgesia choices open; larger trials needed before practice change.
Background: Pain management after cardiac surgery has been based on parenteral long-acting opioids such as morphine. The other alternative is remifentanil. We compared the efficacity of remifentanil vs morphine -metamizole for post cardiac surgery pain relief. Methods; Twenty patients undergoing on-pump coronary artery bypass surgery, receiving standardized propofol–fentanyl and propofol based anesthesia, remifentanil group (Group R, n = 10) and fentanyl (Group F, n = 10). Postoperative analgesia was provided in R group initially with remifentanil and later with morphine-metamizole and in F group immediately after operation. Pain was controlled by visual observation, questioning, in rest and during coughing, with a score (0-3). Results; There is no difference in time of extubation between groups but, pain score was much higher in F (3-9) group in first hour compared with R group (0-4). Morphine requirements was higher in (R) after remifentanil was stopped, in a first hour, but was lower after 24 hours compared with F group. Conclusion: Use of remifentanil is associated with lower scale of pain in postoperative period and lower morphine requirement after 24 hours, when analgesia treatment was changed.
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Ibrahimi et al. (2021) studied Postoperative pain following cardiac surgery (n=20). Remifentanil vs. Morphine-metamizole was evaluated on Pain score in the first hour post-extubation. Remifentanil was associated with lower pain scores in the first postoperative hour and lower morphine requirements after 24 hours compared to morphine-metamizole following cardiac surgery.
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