title: Patient-controlled analgesia after coronary bypass: Remifentanil or sufentanil?
abstract: BACKGROUND
  adequate pain control after cardiac surgery is mandatory to reduce its remarkable morbidity. In this study, we aimed to compare the efficacy of patient-controlled analgesia with remifentanil or sufentanil for pain management after coronary artery bypass grafting.
  
  
  METHODS
  249 patients who underwent coronary artery bypass were randomly assigned to receive patient-controlled analgesia with remifentanil or sufentanil during the first 24 h postoperatively. Pain intensity during patient-controlled analgesia was assessed using 4 different pain rating scales.
  
  
  RESULTS
  patients given remifentanil had lower Visual Analog Scale scores at 24 h compared to those given sufentanil (p = 0.002). The Numeric Rating Scale at 24 h was also significantly lower in patients using remifentanil (p = 0.004). The Faces Pain Scale scores at 4, 18, and 24 h were significantly lower in patients using remifentanil compared to those using sufentanil (p = 0.045, 0.036, and 0.011, respectively). No significant differences between groups were seen in the pain intensity assessed by the Behavior Rating Scale at any time point during the first 24 h postoperatively.
  
  
  CONCLUSIONS
  our study showed that both remifentanil and sufentanil patient-controlled analgesia can provide acceptable analgesia after coronary artery bypass. The difference between their efficacies was inconspicuous until 24 h postoperatively. Remifentanil seems to result in better pain relief at 24 h postoperatively.
authors.affiliation: Department of Cardiac Anesthesiology, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Mostafa
authors.initials: SM
authors.lastname: Alavi
authors.affiliation: Department of Cardiac Anesthesiology, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Mohammadmehran
authors.initials: SM
authors.lastname: Ghoreishi
authors.affiliation: Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran mitra.chitsazan66@yahoo.com.
authors.forename: Mitra
authors.initials: M
authors.lastname: Chitsazan
authors.affiliation: Department of Cardiac Anesthesiology, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Iman
authors.initials: I
authors.lastname: Ghandi
authors.affiliation: Masih Daneshvari Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza Jahangiri
authors.initials: AJ
authors.lastname: Fard
authors.affiliation: Department of Cardiovascular Surgery, Shaheed Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Saeed
authors.initials: SS
authors.lastname: Hosseini
authors.affiliation: Department of Cardiac Anesthesiology, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Maziar
authors.initials: M
authors.lastname: Mahjoobifard
authors.affiliation: Department of Cardiac Anesthesiology, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Kamal
authors.initials: K
authors.lastname: Fani
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D000077208:Remifentanil; D017409:Sufentanil / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D017409:Sufentanil; D000077208:Remifentanil
keywords: Analgesia; Coronary artery bypass; Intraoperative care; Pain; Remifentanil; Sufentanil; patient-controlled; postoperative