Key result
Remifentanil infusion matches fentanyl for hemodynamic stability in pediatric cardiac surgery but yields lower post-sternotomy MAP.
Why the study?
The hemodynamic effects of remifentanil versus fentanyl as intraoperative analgesics in pediatric cardiac surgery were compared to address differences in hemodynamic stability and complications.
Does continuous intravenous remifentanil infusion improve intraoperative hemodynamic stability compared to intermittent intravenous fentanyl in pediatric patients undergoing congenital cardiac surgery?
Observational (n=52)
None
No
Does continuous intravenous remifentanil infusion improve intraoperative hemodynamic stability compared to intermittent intravenous fentanyl in pediatric patients undergoing congenital cardiac surgery?
Absolute Event Rate: 44% vs 53%
p-value: p=0.034
Remifentanil is as effective as fentanyl in maintaining intraoperative hemodynamic stability in pediatric patients undergoing cardiac surgery.
May support remifentanil as fentanyl alternative for stability in pediatric cardiac surgery; hypothesis-generating observational data require randomized confirmation.
Objective: The aim of this prospective observational study was to compare the hemodynamic effects of remifentanil and fentanyl, which are used as intraoperative analgesics in pediatric cardiac surgery. Methods: Patients were divided into two groups as those who received continuous intravenous remifentanil infusion (Group R) or intermittent intravenous fentanyl for intraoperative analgesia (Group F). These groups were compared in terms of hemodynamic characteristics and intraoperative complications. Results: The most common congenital cardiac pathology observed in the patients included in the study was ventricular septal defects (32%). Intraoperative complications occurred in 21 (40%) patients, and ventricular fibrillation was the most common complication (n=6; 11.5%). When the patients in both groups were compared in terms of intraoperative hemodynamic indicators, the mean arterial pressure values of the patients in Group R after sternotomy were significantly lower than those of the patients in Group F (p=0.034). No statistically significant difference was found between the two groups in terms of other hemodynamic indicators. When the two groups were compared in terms of intraoperative complications, the difference was not statistically significant although the number of patients with complications was higher in Group F (p=0.1). Conclusion: As a result of this study, it was found that remifentanil was as effective as fentanyl in maintaining intraoperative hemodynamic stability in patients undergoing pediatric cardiac surgery.
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Uzundere et al. (2021) conducted an observational in Congenital cardiac pathologies (n=52). Remifentanil vs. Fentanyl was evaluated on Mean arterial pressure after sternotomy (p=0.034). Continuous intravenous remifentanil infusion maintained intraoperative hemodynamic stability as effectively as intermittent fentanyl in pediatric cardiac surgery, though mean arterial pressure after sternotomy was significantly lower (44 vs 53 mmHg, p=0.034).
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