title: Remifentanil-induced abdominal pain: a randomised clinical trial.
abstract: Remifentanil is an ultra-short-acting opioid, widely used for induction and maintenance of anaesthesia in various types of operations. We recently noted that a great number of patients receiving remifentanil in their anaesthetic regimen experienced postoperative abdominal pain. As a result, we performed this study to investigate its incidence. This randomised single-blinded clinical trial was conducted on 300 patients who were undergoing elective cataract surgery under general anaesthesia. The patients were randomly divided into two groups. In the control group (n = 150), anaesthesia was induced with fentanyl and propofol and maintained with propofol by infusion and 60% N2O. In the remifentanil group, anaesthesia was induced with remifentanil and propofol and maintained with remifentanil infusion and inhalation of 60% N2O. Atracurium was used for muscle relaxation in both groups. Abdominal pain was observed in 79 patients (52.6%) in the remifentanil group, 10 of whom required a therapeutic intervention, but in only three patients in the control group, none of whom required an intervention (P value = 0.001). Postoperative nausea and vomiting were reported in seven and 10 patients (4.7%) in the remifentanil and control group, respectively. These findings indicate that abdominal pain is very common in patients receiving remifentanil by infusion for cataract surgery.
authors.affiliation: Anesthesiology Department, Imam Reza Hospital, Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Jahanbakhsh
authors.forename: A
authors.initials: A
authors.lastname: Bameshki
authors.forename: P
authors.initials: P
authors.lastname: Khashayar
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D001279:Atracurium / Q000627:therapeutic use; D002387:Cataract Extraction / Q000379:methods; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000453:epidemiology; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D000077208:Remifentanil; D016037:Single-Blind Method
chemical_list: D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D001279:Atracurium; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol