- 作者：Massimiliano Greco ; MD?/sup> ; Giovanni Landoni ; MD?/sup> ; landoni.giovani@hsr.it ; Giuseppe Biondi-Zoccai ; MD&dagger ; ; Luca Cabrini ; MD?/sup> ; Laura Ruggeri ; MD?/sup> ; Nicola Pasculli ; MD?/sup> ; Veronica Giacchi ; MD?/sup> ; Jan Sayeg ; MD?/sup> ; Teresa Greco ; MSc?/sup> ; Alberto Zangrillo ; MD?/sup>
- 关键词：remifentanil ; cardiac surgery ; meta-analysis ; comparative study ; cardiac biomarker ; inotropic drug ; troponin ; anesthesia ; intensive care
- 刊名：Journal of Cardiothoracic and Vascular Anesthesia
- 出版年：2012
- 出版时间：February 2012
- 年：2012
- 卷：26
- 期：1
- 页码：110-116
- 全文大小：1102 K
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 = ?39 min [?44, ?2], p for effect = 0.01, p for heterogeneity < 0.001, I2 = 89 % ); length of hospital stay (WMD = ?.08 days [?.60, ?.57], p for effect < 0.0001, p for heterogeneity = 0.004, I2 = 71 % ); and cardiac troponin-I release (WMD = ?.08 ng/mL [?.93, ?.24], p for effect = 0.03, p for heterogeneity < 0.02, I2 = 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, I2 = 5 % ).
Conclusions
Remifentanil reduces cardiac troponin release, time of mechanical ventilation, and length of hospital stay in patients undergoing cardiac surgery.