Open AccessPostoperative Analgesia with Remifentanil vs Morphine-Metamizole Following Cardiac Surgery
Author(s) -
Alfred Ibrahimi,
Saimir Kuçi,
Ervin Bejko,
Stavri Llazo,
Marsela Goga,
Ermal Likaj,
Selman Dumani,
Ali Refatllari,
Jacob Zeitani
Publication year - 2021
Publication title -
albanian journal of trauma and emergency surgery
Language(s) - English
Resource type - Journals
eISSN - 2616-4922
pISSN - 2521-8778
DOI - 10.32391/ajtes.v5i2.249
Subject(s) - remifentanil , medicine , propofol , anesthesia , metamizole , fentanyl , morphine , cardiac surgery , coronary artery bypass surgery , surgery , analgesic , artery
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 propofol based anesthesia, remifentanil group (Group R, n = 10) and fentanyl (Group F, n = 10). Postoperative analgesia was provided in R group 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.