Remifentanil or sufentanil for coronary surgery: comparison of postoperative respiratory impairment

European Journal of Anaesthesiology
H GuggenbergerH K Eltzschig

Abstract

High-dose opioid anaesthesia contributes to decreasing metabolic and hormonal stress responses in patients undergoing cardiac surgery. However, the increase in context-sensitive half-life of opioids given as a high-dose regimen can affect postoperative respiratory recovery. In contrast, remifentanil can be given in high doses without prolonging context-sensitive half-life due to its rapid metabolism. Therefore, we performed a prospective, randomized trial to compare anaesthesia consisting of propofol/remifentanil or propofol/sufentanil with regard to postoperative respiratory function and outcome. Patients undergoing coronary artery bypass grafting were randomized to a propofol/remifentanil (0.5-1.0 microg kg(-1) min(-1)) or propofol/sufentanil (30-40 ng kg(-1) min(-1)) based anaesthetic. Carbon dioxide response, forced expiratory volume in one second, vital capacity, and functional residual capacity were measured 1 day prior to the operation, 1 h before extubation, 1, 24 and 72 h after extubation. In addition, the incidence of atelectasis, pulmonary infiltrates, intensive care unit and postoperative length of stay were compared. Patients and physicians were blinded to the treatment group. Twenty-five patients in each treatment...Continue Reading

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Citations

Oct 22, 2008·Anesthesia and Analgesia·Sharon A ChungFrances Chung
May 3, 2011·Annales Françaises D'anesthèsie Et De Rèanimation·J AllaryJ-L Bourgain
Jun 3, 2014·Asian Cardiovascular & Thoracic Annals·Seyed Mostafa AlaviKamal Fani
Dec 28, 2012·Critical Care Medicine·Juliana BarrUNKNOWN American College of Critical Care Medicine
Dec 1, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Sung Mee JungJeong Min Park
Aug 9, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Massimiliano GrecoAlberto Zangrillo

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