Remifentanil versus fentanyl for short‐term analgesia‐based sedation in mechanically ventilated postoperative children

Abstract

We conclude that a remifentanil infusion provides clinically comparable analgesia with a fentanyl infusion in mechanically ventilated postoperative pediatric patients. These two drugs are suitable for short-term analgesia-based sedation in pediatric postoperative ICU patients.

Remifentanil–midazolam sedation for paediatric patients receiving mechanical ventilation after cardiac surgery †

“…Three of 11 children received supplementary propofol with the remainder receiving remifentanil alone. 8 The majority of our patients had undergone CPB and were likely significantly 'sicker' than those described earlier. In addition, they were receiving their remifentanil infusions after a substantial dose of fentanyl which may have altered subsequent opioid sensitivity.…”

“…Three samples were collected during the first 25 min of remifentanil infusion; nine sampling points were divided into three sampling blocks (1, 2, or 3 min), (5, 8, or 10 min), (15, 20, or 25 min), and each patient was randomized to one sampling time per block. A further three samples were collected during the 20 min after the first reduction in remifentanil infusion rate when again, each patient was randomized to one sampling time per block (1, 2, or 3 min), (5,8, or 10 min), (12, 15, or 20 min). Further samples were obtained 20 min after the second and subsequent reductions in remifentanil infusion rate (up to a maximum of five samples) and a final sample was collected at the point of arousal.…”

Remifentanil/midazolam versus fentanyl/midazolam for analgesia and sedation of mechanically ventilated neonates and young infants: a randomized controlled trial

“…There were no major side effects and the mean extubation time was significantly shorter in the remifentanil group (106 vs. 1,320 min). Akinci et al [16] Interval Random n Allocatio Fig. 3 Heart rate during study medication.…”

Sedation in Critically Ill Children with Respiratory Failure

“…Morphine stimulates the release of histamine and inhibits compensatory sympathetic responses, leading to vasodilation and consequently hypotension, particularly following bolus administration (46). The opioid fentanyl has powerful analgesic properties and provides some sedation, as demonstrated in a randomized controlled trial comparing continuous fentanyl and remifentanil in postoperative orthopedic children (47). No studies are available for the use of fentanyl for long-term sedation in PICU.…”