Remifentanil in cardiac surgery: A meta-analysis of randomized controlled trials

Massimiliano Greco, Giovanni Landoni, Giuseppe Biondi-Zoccai, Luca Cabrini, Laura Ruggeri, Nicola Pasculli, Veronica Giacchi, Jan Sayeg, Teresa Greco, Alberto Zangrillo

Research output: Contribution to journalArticle

Abstract

Objective: The authors conducted a review of randomized controlled trials to identify advantages in clinically relevant outcomes in patients undergoing cardiac surgery with remifentanil. Design: Meta-analysis. Setting: Hospitals. Participants: A total of 1,473 patients from 16 randomized trials. Interventions: None. Measurements and Main Result: PubMed, BioMedCentral, and conference proceedings were searched (updated May 2010) for randomized trials that compared remifentanil with fentanyl or sufentanil in cardiac anesthesia. Four independent reviewers performed data extraction, with divergences resolved by consensus. Overall analysis showed that the use of remifentanil was associated with a significant reduction in postoperative mechanical ventilation (WMD = -139 min [-244, -32], p for effect = 0.01, p for heterogeneity <0.001, I 2 = 89%); length of hospital stay (WMD = -1.08 days [-1.60, -0.57], p for effect <0.0001, p for heterogeneity = 0.004, I 2 = 71%); and cardiac troponin-I release (WMD = -2.08 ng/mL [-3.93, -0.24], p for effect = 0.03, p for heterogeneity <0.02, I 2 = 74%). No difference was noted in mortality (3/344 [0.87%] in the remifentanil group vs [1.06%] the control group, OR 0.76 [0.17-3.38], p for effect = 0.72, p for heterogeneity = 0.35, I 2 = 5%). Conclusions: Remifentanil reduces cardiac troponin release, time of mechanical ventilation, and length of hospital stay in patients undergoing cardiac surgery.

Original languageEnglish
Pages (from-to)110-116
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume26
Issue number1
DOIs
Publication statusPublished - Feb 2012

Keywords

  • anesthesia
  • cardiac biomarker
  • cardiac surgery
  • comparative study
  • inotropic drug
  • intensive care
  • meta-analysis
  • remifentanil
  • troponin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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