Background:Pain management after cardiac surgery has been based on parenteral long-acting opioids such as morphine. the other alternative is remifentanil. We compared the efficacity of remifentanil vs morphine -metamizole for post cardiac surgery pain relief. Methods; twenty patients undergoing on-pump coronary artery bypass surgery, receiving standardized propofol–fentanyl and propo-fol based anesthesia, remifentanil group (group r, n = 10) and fentanyl (group F, n = 10). Postoperative analgesia was provided in rgroup initially with remifentanil and later with morphine-metamizole and in F group immediately after operation. Pain was controlled by visual observation, questioning, in rest and during coughing, with a score (0-3). Results: There is no difference in time of extubation between groups but, pain score was much higher in F (3-9) group in first hour compared with R group (0-4). Morphine requirements was higher in (R) after remifentanil was stopped, in a first hour, but was lower after 24 hours compared with F group. Conclusion: Use of remifentanil is associated with lower scale of pain in postoperative period and lower morphine requirement after 24 hours, when analgesia treatment was changed
Postoperative Analgesia with Remifentanil vs Morphine-Metamizole Following Cardiac Surgery
Jacob Zeitani
2021
Abstract
Background:Pain management after cardiac surgery has been based on parenteral long-acting opioids such as morphine. the other alternative is remifentanil. We compared the efficacity of remifentanil vs morphine -metamizole for post cardiac surgery pain relief. Methods; twenty patients undergoing on-pump coronary artery bypass surgery, receiving standardized propofol–fentanyl and propo-fol based anesthesia, remifentanil group (group r, n = 10) and fentanyl (group F, n = 10). Postoperative analgesia was provided in rgroup initially with remifentanil and later with morphine-metamizole and in F group immediately after operation. Pain was controlled by visual observation, questioning, in rest and during coughing, with a score (0-3). Results: There is no difference in time of extubation between groups but, pain score was much higher in F (3-9) group in first hour compared with R group (0-4). Morphine requirements was higher in (R) after remifentanil was stopped, in a first hour, but was lower after 24 hours compared with F group. Conclusion: Use of remifentanil is associated with lower scale of pain in postoperative period and lower morphine requirement after 24 hours, when analgesia treatment was changedI documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
