Postoperative opioid usage in children receiving Remifentanil vs. sufentanil

Background

Studies have found a 30–50% increase in postoperative opioid demand following intraoperative use of remifentanil infusion, suggesting development of acute opioid tolerance. This study was undertaken to compare postoperative opioid requirements in children who received remifentanil versus sufentanil infusions during spine fusion.

Methods

A secondary review of data from children 8–18 years of age, who had undergone spine fusion was conducted. Patients who had received remifentanil infusions were matched by age, procedure, and duration of anaesthesia to those who received sufentanil infusions. Data included patient demographics, total intraoperative and postoperative opioids, and self-reported pain scores. Postoperative pain was managed with morphine patient controlled analgesia, and acetaminophen and diazepam as needed.

Results

Forty-four children (13.5 ± 3 years) were included. Demographic and procedural data were similar between groups. There were no differences between remifentanil or sufentanil groups in high pain scores (5.3 ± 2.4 vs. 5.7 ± 2.6, respectively) or cumulative morphine requirements (1.02 ± 0.32 mg/kg vs. 1.07 ± 0.48 mg/kg) during the first 24 h after surgery.

Conclusion

This study found no difference in opioid consumption between children who received remifentanil versus sufentanil infusions. Findings suggest that these short-acting potent opioids similarly affect morphine requirements following spine fusion.