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Use of remifentanil as a sedative agent in critically ill adult patients: a meta‐analysis
Author(s) -
Tan J. A.,
Ho K. M.
Publication year - 2009
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2009.06129.x
Subject(s) - remifentanil , medicine , sedative , sedation , anesthesia , meta analysis , intensive care unit , mechanical ventilation , critically ill , randomized controlled trial , intensive care medicine , propofol , surgery
Summary This meta‐analysis examined the benefits of using remifentanil as a sedative agent in critically ill patients. A total of 11 randomised controlled trials, comparing remifentanil with another opioid or hypnotic agent in 1067 critically ill adult patients, were identified from the Cochrane controlled trials register and EMBASE and MEDLINE databases, and subjected to meta‐analysis. Remifentanil was associated with a reduction in the time to tracheal extubation after cessation of sedation (weighted‐mean‐difference −2.04 h (95% CI −0.39 to −3.69 h); p = 0.02). Remifentanil was, however, not associated with a significant reduction in mortality (relative risk 1.01 (95% CI 0.67–1.52); p = 0.96), duration of mechanical ventilation, length of intensive care unit stay, and risk of agitation (relative risk 1.08 (95% CI 0.64–1.82); p = 0.77) when compared to an alternative sedative or analgesic agent. The current evidence does not support the routine use of remifentanil as a sedative agent in critically ill adult patients.