Arrêt journalier de la sédation en réanimation chez l'insuffisant rénal: rémifentanil–midazolam versus fentanyl–midazolam

Amor, M. Belhadj; Ouezini, R.; Lamine, K; Barakette, M; Labbène, Iheb; Ferjani, Mustapha

doi:10.1016/j.annfar.2007.10.005

Cited by 14 publications

(1 citation statement)

References 9 publications

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“…We screened titles and abstracts to identify potentially eligible studies and retrieved 41 manuscripts for full-text review. Twenty-six of those studies were excluded: 4 studies were not in English or Chinese, [13][14][15][16] 12 did not include the relevant outcomes for systematic review, [17][18][19][20][21][22][23][24][25][26][27][28] 5 were not set in the ICU, [29][30][31][32][33] 3 studies using remifentanil versus non-opioid for sedation, [34][35][36] and 2 studies are not RCTs. [37,38] In total, 15 studies [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] were eligible and included in this systemic review, which ultimately included 1233 subjects.…”

Section: Study Identification and Selectionmentioning

confidence: 99%

Comparison between remifentanil and other opioids in adult critically ill patients

et al. 2021

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Background and aims: To identify the efficacy and safety of remifentanil when compared with other opioids in adult critically ill patients. Methods: We searched for studies in the Cochrane Library, MEDLINE, and EMBASE that had been published up to May 31st, 2019. Randomized clinical trials using remifentanil comparing with other opioids for analgesia were included. Two reviewers independently applied eligibility criteria, assessed quality, and extracted data. Duration of mechanical ventilation was the primary outcome, and secondary outcomes included weaning time, intensive care unit (ICU), length of stay (LOS), hospital LOS, mortality, side effects, and costs. Results: Fifteen studies with 1233 patients were included. Remifentanil was associated with a significant reduction in the duration of mechanical ventilation in the adult ICU patients when compared with other opioids ( P = .01). Remifentanil also reduced the weaning time ( P = .02) and the ICU LOS when compared with other opioids ( P = .01). There was no difference in the hospital LOS ( P = .15), side effects ( P = .39), and mortality ( P = .79) between remifentanil and other opioids, what's more, remifentanil increased the costs of anesthesia ( P < .001) but did not increase cost of hospitalization ( P = .30) when comparing with other opioids. Conclusions: Remifentanil reduced the duration of mechanical ventilation, weaning time, and ICU LOS when compared with other opioids in adult critically ill patients. Higher quality RCTs are necessary to prove our findings. PROSPERO registration number: CRD42016041438.

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Section: Study Identification and Selectionmentioning

confidence: 99%

Comparison between remifentanil and other opioids in adult critically ill patients

et al. 2021

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Remifentanil-propofol analgo-sedation shortens duration of ventilation and length of ICU stay compared to a conventional regimen: a centre randomised, cross-over, open-label study in the Netherlands

et al. 2008

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A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients

et al. 2010

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A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients Abstract Purpose: To compare the quality of analgesia provided by a remifentanil-based analgesia regime with that provided by a fentanylbased regime in critically ill patients. Methods: This was a registered, prospective, two-center, randomized, triple-blind study involving adult medical and surgical patients requiring mechanical ventilation (MV) for more than 24 h. Patients were randomized to either remifentanil infusion or a fentanyl infusion for a maximum of 30 days. Sedation was provided using propofol (and/or midazolam if required). Results: Primary outcome was the proportion of patients in each group maintaining a target analgesia score at all time points. Secondary outcomes included duration of MV, discharge times, and morbidity. At planned interim analysis (n = 60), 50% of remifentanil patients (n = 28) and 63% of fentanyl patients (n = 32) had maintained target analgesia scores at all time points (p = 0.44). There were no significant differences between the groups with respect to mean duration of ventilation (135 vs. 165 h, p = 0.80), duration of hospital stay, morbidity, or weaning. Interim analysis strongly suggested futility and the trial was stopped. Conclusions: The use of remifentanil-based analgesia in critically ill patients was not superior regarding the achievement and maintenance of sufficient analgesia compared with fentanyl-based analgesia.

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Arrêt journalier de la sédation en réanimation chez l'insuffisant rénal: rémifentanil–midazolam versus fentanyl–midazolam

Cited by 14 publications

References 9 publications

Comparison between remifentanil and other opioids in adult critically ill patients

Comparison between remifentanil and other opioids in adult critically ill patients

Remifentanil-propofol analgo-sedation shortens duration of ventilation and length of ICU stay compared to a conventional regimen: a centre randomised, cross-over, open-label study in the Netherlands

A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients

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