Use of Remifentanil as a Sedative Agent in Critically Ill Adult Patients: a Meta-Analysis


J. A. Tan and K. M. Ho


Anaesthesia, 2009, 64 


This meta-analysis examined the benefits of using remifentanil as a sedative agent in critically ill patients. The Cochrane controlled trials register and EMBASE and MEDLINE databases identified a total of 11 randomised controlled trials, comparing remifentanil with another opioid or hypnotic agent in 1067 critically ill adult patients and subjected to meta-analysis. Remifentanil was associated with a reduction in the time to tracheal extubation after cessation of sedation (weighted-mean-difference – 2.04 h (95% CI – 0.39 to – 3.69 h); p = 0.02). However, remifentanil was not associated with a significant reduction in mortality (relative risk 1.01 (95% CI 0.67–1.52); p = 0.96), duration of mechanical ventilation, length of intensive care unit stay and risk of agitation (relative risk 1.08 (95% CI 0.64–1.82); p = 0.77), when compared to an alternative sedative or analgesic agent. The current evidence does not support the routine use of remifentanil as a sedative agent in critically ill adult patients.



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