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Intensive Care Medicine
Published in: Intensive Care Medicine 3/2011

01-03-2011 | Original

A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients

Authors: Claudia Spies, Martin MacGuill, Anja Heymann, Christina Ganea, Daniel Krahne, Angelika Assman, Heinrich-Rudolf Kosiek, Kathrin Scholtz, Klaus-Dieter Wernecke, Jörg Martin

Published in: Intensive Care Medicine | Issue 3/2011

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Abstract

Purpose

To compare the quality of analgesia provided by a remifentanil-based analgesia regime with that provided by a fentanyl-based regime in critically ill patients.

Methods

This was a registered, prospective, two-center, randomized, triple-blind study involving adult medical and surgical patients requiring mechanical ventilation (MV) for more than 24 h. Patients were randomized to either remifentanil infusion or a fentanyl infusion for a maximum of 30 days. Sedation was provided using propofol (and/or midazolam if required).

Results

Primary outcome was the proportion of patients in each group maintaining a target analgesia score at all time points. Secondary outcomes included duration of MV, discharge times, and morbidity. At planned interim analysis (n = 60), 50% of remifentanil patients (n = 28) and 63% of fentanyl patients (n = 32) had maintained target analgesia scores at all time points (p = 0.44). There were no significant differences between the groups with respect to mean duration of ventilation (135 vs. 165 h, p = 0.80), duration of hospital stay, morbidity, or weaning. Interim analysis strongly suggested futility and the trial was stopped.

Conclusions

The use of remifentanil-based analgesia in critically ill patients was not superior regarding the achievement and maintenance of sufficient analgesia compared with fentanyl-based analgesia.
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Metadata
Title
A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients
Authors
Claudia Spies
Martin MacGuill
Anja Heymann
Christina Ganea
Daniel Krahne
Angelika Assman
Heinrich-Rudolf Kosiek
Kathrin Scholtz
Klaus-Dieter Wernecke
Jörg Martin
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 3/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-010-2100-5

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