Objective: The authors conducted a review of randomized controlled trials to identify advantages in clinically relevant outcomes in patients undergoing cardiac surgery with remifentanil. Design: Meta-analysis. Setting: Hospitals. Participants: A total of 1,473 patients from 16 randomized trials. Interventions: None. Measurements and Main Result: PubMed, BioMedCentral, and conference proceedings were searched (updated May 2010) for randomized trials that compared remifentanil with fentanyl or sufentanil in cardiac anesthesia. Four independent reviewers performed data extraction, with divergences resolved by consensus. Overall analysis showed that the use of remifentanil was associated with a significant reduction in postoperative mechanical ventilation (WMD 139 min [244 , 32], p for effect 0.01, p for heterogeneity < 0.001, I2 89%); length of hospital stay (WMD 1.08 days [1.60, 0.57], p for effect < 0.0001, p for heterogeneity 0.004, I2 71%); and cardiac troponin-I release (WMD 2.08 ng/mL [3.93, 0.24], p for effect 0.03, p for heterogeneity < 0.02, I2 74%). No difference was noted in mortality (3/344 [0.87%] in the remifentanil group vs [1.06%] the control group, OR 0.76 [0.17-3.38], p for effect 0.72, p for heterogeneity 0.35, I2 5%). Conclusions: Remifentanil reduces cardiac troponin release, time of mechanical ventilation, and length of hospital stay in patients undergoing cardiac surgery.

Remifentanil in Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials

CABRINI L;
2012-01-01

Abstract

Objective: The authors conducted a review of randomized controlled trials to identify advantages in clinically relevant outcomes in patients undergoing cardiac surgery with remifentanil. Design: Meta-analysis. Setting: Hospitals. Participants: A total of 1,473 patients from 16 randomized trials. Interventions: None. Measurements and Main Result: PubMed, BioMedCentral, and conference proceedings were searched (updated May 2010) for randomized trials that compared remifentanil with fentanyl or sufentanil in cardiac anesthesia. Four independent reviewers performed data extraction, with divergences resolved by consensus. Overall analysis showed that the use of remifentanil was associated with a significant reduction in postoperative mechanical ventilation (WMD 139 min [244 , 32], p for effect 0.01, p for heterogeneity < 0.001, I2 89%); length of hospital stay (WMD 1.08 days [1.60, 0.57], p for effect < 0.0001, p for heterogeneity 0.004, I2 71%); and cardiac troponin-I release (WMD 2.08 ng/mL [3.93, 0.24], p for effect 0.03, p for heterogeneity < 0.02, I2 74%). No difference was noted in mortality (3/344 [0.87%] in the remifentanil group vs [1.06%] the control group, OR 0.76 [0.17-3.38], p for effect 0.72, p for heterogeneity 0.35, I2 5%). Conclusions: Remifentanil reduces cardiac troponin release, time of mechanical ventilation, and length of hospital stay in patients undergoing cardiac surgery.
2012
Greco, M; Landoni, G; Biondi-Zoccai, Gg; Cabrini, L; Ruggeri, L; Pasculli, N; Giacchi, V; Sayeg, J; Greco, T; Zangrillo, A
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2086015
 Attenzione

L'Ateneo sottopone a validazione solo i file PDF allegati

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact