Review of the efficacy and safety of remifentanil for the prevention and treatment of pain during and after procedures and surgery

Figures & data

Table 1 Studies of remifentanil use during general anesthesia

Study	Surgery	Control group	Study group	N	Recovery time	PONV	Discharge time	Postoperative pain
Song et al^Citation11	Gyn	Des titration and N2O	Remi titration, with Des 2%, N2O	46	>control group	No difference	NR	No difference
Beers et al^Citation12	Gyn	Fentanyl	Remi	34	No difference	>study group	NR	No difference
Hong et al^Citation13	Breast	Sevo/N2O/Fentanyl	Remi/propofol	42	>control group	>control group	Similar	>study group
Larsen et al^Citation14	Orthopedic	Sevo/N2O or Des/N20	Remi/propofol	60	>control groups	No difference	NR	No difference
Davis et al^Citation15	Pediatric tonsil/adenoid	Sevo/fentanyl or Hal/fentanyl	Sevo/remi or Hal/remi	206	>control groups	No difference	No difference	>study group
Eltzschig et al^Citation16	Pediatric strabismus	Fentanyl	Remi	81	NR	>control group	NR	>study group early

Table 2 Studies of remifentanil use with regional anesthesia

Study	Surgery	Type of regional	Control group	Study group	N	Measured outcome	Adverse effects
Lauwers et al^Citation19	Orthopedic	Spinal or brachial plexus	Placebo with midazolam	Remifentanil infusion with midazolam	160	>sedation and <midazolam required in study group	Respiratory depression, PONV, pruritis
Lauwers et al^Citation20	Orthopedic	Spinal or axillary	Propofol infusion	Remifentanil infusion	28	Sedation and comfort equal	>respiratory depression and nausea in study group
Mingus et al^Citation21	Orthopedic or urologic	Spinal, axillary or ankle	Propofol infusion	Remifentanil infusion	107	>pain relief in study group	>respiratory depression and nausea in study group
Krenn et al^Citation23	Carotid endarterectomy	Cervical plexus	Propofol infusion	Remifentanil	60	No difference in sedation or hemodynamic variables	>respiratory depression and PaCO2 in study group
Servin et al^Citation22	Orthopedic, urologic, gynecologic, vascular	Neuraxial or peripheral block	Propofol	Remifentanil	125	>pain relief in study group	>respiratory depression and nausea in study group

Table 3 Studies of remifentanil as an analgesic

Study	Surgery	Control group	Study group	N	Pain scores	PONV	Adverse events
Choi et al^Citation28	Abdominal hysterectomy	Fentanyl infusion	Remifentanil infusion	56	No difference	No difference	Respiratory depression in study group
Kucukemre et al^Citation30	Abdominal surgery	Morphine PCA	Remifentanil PCA	60	No difference	No difference	Apnea after loading dose of remifentanil in one patient
Gurbet et al^Citation31	Cardiac Surgery	Morphine or Fentanyl PCA	Remifentanil PCA	75	No difference	>morphine group	Pruritis in fentanyl group
Baltali et al^Citation32	Cardiac surgery	Morphine PCA	Remifentanil PCA	60	<pain with cough and movement in study group	No difference	No difference
Volmanen et al^Citation35	Labor analgesia	Epidural bupivicaine	Remifentanil PCA	52	< pain in control group	>study group	Maternal desaturation, sedation in study group

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