sedation and analgesia in intensive care a comparison of fentanyl and remifentanil镇静和镇痛在重症监护比较芬太尼和remifentanil.pdfVIP

Hindawi Publishing Corporation Pain Research and Treatment Volume 2011, Article ID 650320, 9 pages doi:10.1155/2011/650320 Clinical Study Sedation and Analgesia in Intensive Care: A Comparison of Fentanyl and Remifentanil F. Cevik,1 M. Celik,2 P. M. Clark,3 and C. Macit3 1 Medical Department, Abbott Pharmaceuticals, Meral Plaza, Umraniye, Istanbul, Turkey 2 ICU Department, Ministry of Health Teaching and Research Hospital, G¨oztepe, Istanbul, Turkey 3 Yeditepe University School of Pharmacy, 26 August Campus, 34755 Atasehir, Istanbul, Turkey Correspondence should be addressed to P. M. Clark, pmclark@.tr Received 2 September 2010; Revised 18 April 2011; Accepted 1 May 2011 Academic Editor: Steve McGaraughty Copyright © 2011 F. Cevik et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Optimal sedation and analgesia are of key importance in intensive care. The aim of this study was to assess the quality of sedoanalgesia and outcome parameters in regimens containing midazolam and either fentanyl or remifentanil. A prospective, randomized, open-label, controlled trial was carried out in the ICU unit of a large teaching hospital in Istanbul over a 9-month period. Thirty-four patients were randomly allocated to receive either a remifentanil-midazolam regimen (R group, n = 17) or a fentanyl-midazolam regimen (F group, n = 17). A strong correlation between Riker Sedation-Agitation Scale (SAS) and Ramsey Scale (RS) measurements was observed. Comparatively, remifentanil provided significantly more potent and rapid analgesia based on Behavioral-Physiological Scale (BPS) measurements and a statist