Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials
Introduction: Remifentanil is a short-acting opioid and can be administered during surgery without the risk of delayed postoperative recovery but concerns about hyperalgesia and the shortages of remifentanil lead anesthetists to consider long-acting opioids for Total Intravenous Anesthesia (TIVA). S...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Brazilian Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001424000800 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832575514671316992 |
|---|---|
| author | Igor Seror Cuiabano Rafael Pagliaro Naves Rodrigo Bouchabki de A. Diehl |
| author_facet | Igor Seror Cuiabano Rafael Pagliaro Naves Rodrigo Bouchabki de A. Diehl |
| author_sort | Igor Seror Cuiabano |
| collection | DOAJ |
| description | Introduction: Remifentanil is a short-acting opioid and can be administered during surgery without the risk of delayed postoperative recovery but concerns about hyperalgesia and the shortages of remifentanil lead anesthetists to consider long-acting opioids for Total Intravenous Anesthesia (TIVA). Sufentanil is a more potent opioid with a longer context-sensitive half-life but can promote good postoperative analgesia due to its residual effect. This meta-analysis aimed to compare the recovery profile of remifentanil and sufentanil for TIVA. Methods: The search strategy was performed in PubMed, CENTRAL, and Web of Science for RCTs comparing sufentanil and remifentanil as part of TIVA in adults undergoing noncardiac surgery. Risk of bias and the quality of evidence were performed using RoB2 and GRADEpro, respectively. The primary outcome was time to tracheal extubation. Secondary analyses included postoperative analgesia, respiratory depression, and Postoperative Nausea and Vomiting (PONV). Results: Sufentanil increases the time to extubate, MD = 4.29 min; 95% CI: 2.33 to 6.26; p = 0.001. It also reduces the need for postoperative rescue analgesia, logOR = -1.07; 95% CI: -1.62 to -0.52; p = 0.005. There were no significant differences between both opioids for PONV, logOR = 0.50; 95% CI: -0.10 to 1.10; p = 0.10 and respiratory depression, logOR = 1.21; 95% CI: -0.42 to 2.84; p = 0.15. Conclusion: Sufentanil delays the time to tracheal extubation compared with remifentanil but is associated with a reduced need for postoperative rescue analgesia. No significant differences were observed between the two opioids in terms of postoperative respiratory depression or PONV. |
| format | Article |
| id | doaj-art-5965840364e04090a7d92720d698254d |
| institution | Kabale University |
| issn | 0104-0014 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj-art-5965840364e04090a7d92720d698254d2025-02-01T04:11:31ZengElsevierBrazilian Journal of Anesthesiology0104-00142025-01-01751844558Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trialsIgor Seror Cuiabano0Rafael Pagliaro Naves1Rodrigo Bouchabki de A. Diehl2Centro Universitário de Várzea Grande, Curso de Medicina, Várzea Grande, MT, Brazil; Hospital de Cancer de Mato Grosso, Departamento de Anestesia, Cuiabá, MT, Brazil; Corresponding author.Hospital São Mateus, Departamento de Anestesia, Cuiabá, MT, BrazilHospital de Cancer de Mato Grosso, Departamento de Anestesia, Cuiabá, MT, BrazilIntroduction: Remifentanil is a short-acting opioid and can be administered during surgery without the risk of delayed postoperative recovery but concerns about hyperalgesia and the shortages of remifentanil lead anesthetists to consider long-acting opioids for Total Intravenous Anesthesia (TIVA). Sufentanil is a more potent opioid with a longer context-sensitive half-life but can promote good postoperative analgesia due to its residual effect. This meta-analysis aimed to compare the recovery profile of remifentanil and sufentanil for TIVA. Methods: The search strategy was performed in PubMed, CENTRAL, and Web of Science for RCTs comparing sufentanil and remifentanil as part of TIVA in adults undergoing noncardiac surgery. Risk of bias and the quality of evidence were performed using RoB2 and GRADEpro, respectively. The primary outcome was time to tracheal extubation. Secondary analyses included postoperative analgesia, respiratory depression, and Postoperative Nausea and Vomiting (PONV). Results: Sufentanil increases the time to extubate, MD = 4.29 min; 95% CI: 2.33 to 6.26; p = 0.001. It also reduces the need for postoperative rescue analgesia, logOR = -1.07; 95% CI: -1.62 to -0.52; p = 0.005. There were no significant differences between both opioids for PONV, logOR = 0.50; 95% CI: -0.10 to 1.10; p = 0.10 and respiratory depression, logOR = 1.21; 95% CI: -0.42 to 2.84; p = 0.15. Conclusion: Sufentanil delays the time to tracheal extubation compared with remifentanil but is associated with a reduced need for postoperative rescue analgesia. No significant differences were observed between the two opioids in terms of postoperative respiratory depression or PONV.http://www.sciencedirect.com/science/article/pii/S0104001424000800Opioid AnalgesicsSufentanilRemifentanilPropofolIntravenous anesthesiaAnesthesia recovery period |
| spellingShingle | Igor Seror Cuiabano Rafael Pagliaro Naves Rodrigo Bouchabki de A. Diehl Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials Brazilian Journal of Anesthesiology Opioid Analgesics Sufentanil Remifentanil Propofol Intravenous anesthesia Anesthesia recovery period |
| title | Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia a systematic review and meta analysis of randomized controlled trials |
| topic | Opioid Analgesics Sufentanil Remifentanil Propofol Intravenous anesthesia Anesthesia recovery period |
| url | http://www.sciencedirect.com/science/article/pii/S0104001424000800 |
| work_keys_str_mv | AT igorserorcuiabano comparisonoftherecoveryprofileofsufentanilandremifentanilintotalintravenousanesthesiaasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT rafaelpagliaronaves comparisonoftherecoveryprofileofsufentanilandremifentanilintotalintravenousanesthesiaasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT rodrigobouchabkideadiehl comparisonoftherecoveryprofileofsufentanilandremifentanilintotalintravenousanesthesiaasystematicreviewandmetaanalysisofrandomizedcontrolledtrials |