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Remifentanil use in pediatric scoliosis surgery-an effective alternative to morphine (a retrospective study)

Ibrahim Abu-Kishk1, Roei Hod-Feins, Yoram Anekstein

  • 1Pediatric Intensive Care Unit, Assaf Harofeh Medical Center, Zerifin 70300, Israel. fredricag@asaf.health.gov.il

Yonsei Medical Journal
|August 8, 2012
PubMed

Insights

Remifentanil anesthesia in pediatric scoliosis surgery leads to shorter operating times and faster extubation. This approach reduces intensive care unit needs without increasing complication rates, making it a safe and effective option.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Spinal Fusion

Background:

  • Remifentanil offers unique properties for pediatric anesthesia.
  • Concerns exist regarding its high potency and limited clinical trials in children.
  • Adverse events are a consideration in pediatric potent anesthetic use.

Purpose of the Study:

  • To evaluate the efficacy of remifentanil in pediatric scoliosis surgery.
  • To compare remifentanil with morphine anesthesia in this patient population.
  • To consolidate preliminary findings on remifentanil's use in pediatric spinal fusion.

Main Methods:

  • Retrospective review of medical charts for children undergoing spinal fusion (1998-2007).
  • Patients divided into remifentanil and morphine anesthesia groups.
  • Comparison of demographic, surgical, and postoperative data.

Main Results:

  • Remifentanil group showed significantly earlier extubation (all patients) versus morphine group (2/84 patients).
  • Shorter surgical duration observed in the remifentanil group (5.6 vs. 7.14 hours).
  • Fewer remifentanil patients required intensive care, with no significant increase in major or minor complications.

Conclusions:

  • Remifentanil anesthesia can reduce operating time and facilitate early extubation in pediatric scoliosis surgery.
  • It decreases the need for intensive care hospitalization post-surgery.
  • Remifentanil use is associated with comparable safety profiles to morphine regarding complications.
Abstract

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