Remifentanil versus fentanyl for short-term analgesia-based sedation in mechanically ventilated postoperative children.
BACKGROUND
Analgesia-based sedation techniques are becoming more established in the intensive care unit (ICU) setting. The aim of this study was to compare remifentanil and fentanyl infusions for postoperative analgesia in pediatric ICU patients.


METHODS
After receiving ethical committee approval, a prospective randomized, double-blind study was performed. Twenty-two postoperative orthopedic surgery patients received either remifentanil 0.1 microg.kg(-1).min(-1) or fentanyl 0.025 microg.kg(-1).min(-1) infusions diluted to the same volume. Analgesic infusion was titrated to predefined levels of analgesia [behavioral pain scale (BPS) score of 3]. Propofol was added if sedation was unsatisfactory after BPS score 3 had been achieved.


RESULTS
There were no differences in groups regarding demographics, tracheal extubation times, and pain scores of the patients. After cessation of the opioid infusion, the sedation scores and the heart rates were always higher in the remifentanil group compared with the fentanyl group. The incidences of nausea, vomiting, apnea, desaturation, reintubation within 24 h and constipation were also similar between the two groups.


CONCLUSIONS
We conclude that a remifentanil infusion provides clinically comparable analgesia with a fentanyl infusion in mechanically ventilated postoperative pediatric patients. These two drugs are suitable for short-term analgesia-based sedation in pediatric postoperative ICU patients.
Akinci
Seda Banu
SB
Department of Anaesthesiology and Reanimation, Hacettepe University, Ankara, Turkey. sedabanu@hacettepe.edu.tr
Kanbak
Meral
M
Guler
Aygun
A
Aypar
Ulku
U
D000293:Adolescent; D000701:Analgesics, Opioid; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D010880:Piperidines; D000077208:Remifentanil; D012121:Respiration, Artificial
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl