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Pain Research and Treatment
Volume 2011 (2011), Article ID 650320, 9 pages
http://dx.doi.org/10.1155/2011/650320
Clinical Study

Sedation and Analgesia in Intensive Care: A Comparison of Fentanyl and Remifentanil

1Medical Department, Abbott Pharmaceuticals, Meral Plaza, Umraniye, Istanbul, Turkey
2ICU Department, Ministry of Health Teaching and Research Hospital, Göztepe, Istanbul, Turkey
3Yeditepe University School of Pharmacy, 26 August Campus, 34755 Atasehir, Istanbul, Turkey

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.

Abstract

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 = 1 7 ) or a fentanyl-midazolam regimen (F group, 𝑛 = 1 7 ). 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 statistically nonsignificantly shorter time to discharge. On the other hand, remifentanil also caused a significantly sharper fall in heart rate within the first six hours of treatment.