Remifentanil Compared With Sufentanil Does Not Enhance Fast-Track Possibilities in Cardiac Surgery—A Randomized Study

Randomized Controlled Trial on the Influence of Intraoperative Remifentanil versus Fentanyl on Acute and Chronic Pain after Cardiac Surgery

“…However, when reviewed from a patient point of view, the advantages of remifentanil are questionable. In addition to worse pain outcomes, postoperative cognitive dysfunction and recovery after fast‐track surgery were not improved when remifentanil was compared to long‐acting sufentanil . In light of these results, clinicians should outweigh the proposed benefits of remifentanil against the suggested negative impact for the patients, such as the impact on postoperative pain, knowing that several alternatives for remifentanil are available and that a lower dose of remifentanil decreases the risk for development of chronic pain during the first couple of months.…”

Blood cardioplegia benefits only patients with a long cross-clamp time

“…Throughout the years from which data was collected and, especially, from the year 2012, a reduced postoperative ventilation time was sought in the department. 19–21 This might partly explain the shorter median ventilation times in the BC group. Nevertheless, a ventilation time above 600 minutes was considered atypical during the entire period and must, therefore, be interpreted as a consequence of complicated ventilation weaning.…”

Remifentanil-based propofol-supplemented vs. balanced sevoflurane-sufentanil anesthesia regimens on bispectral index recovery after cardiac surgery: a randomized controlled study

“…The extubation time in Group-PR was significantly shorter (7 h vs. 15 h in Group-C). Bhavsar et al [ 23 ] showed that remifentanil regimen was more effective in reducing time to tracheal extubation and length of stay in the recovery area. Furthermore, the dosage of the intermediate-acting opioid (e.g., morphine, fentanyl, sufentanil) administered during the intraoperative period is also important: higher intraoperative dosage would prolong postoperative extubation time (duration of intubation, odds ratio, 1.54 per sufentanil 1 μg/kg increment) [ 22 ].…”

“…Lison et al [ 8 ] showed no difference in the ventilatory weaning times after using remifentanil vs. sufentanil anesthesia cardiac surgery, although the extubation time was faster in remifentanil anesthesia. Bhavsar et al [ 23 ] also showed that remifentanil anesthesia was not superior to a standard moderate- to high-dose sufentanil regimen in the duration of ventilatory support or ICU stay [ 17 , 21 , 23 ]. Furthermore, some reports showed that early extubation (< 6 postoperative hours) paradoxically increases ICU length of stay in cardiac patients [ 24 , 25 ].…”