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British Journal of Anaesthesia, 2001, Vol. 86, No. 6 763-768
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Recovery after remifentanil and sufentanil for analgesia and sedation of mechanically ventilated patients after trauma or major surgery

S. Soltész1, A. Biedler1, M. Silomon1, I. Schöpflin1 and G. P. Molter2

1Klinik für Anaesthesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, D-66421 Homburg, Germany. 2Klinik für Anaesthesiologie und operative Intensivmedizin, Klinikum Leverkusen, Dhünnberg 60, D-51375 Leverkusen, Germany*Corresponding author

We investigated the analgesic effect and the neurological recovery time after administration of remifentanil in mechanically ventilated patients in an intensive care unit. Twenty patients, after trauma or major surgery with no intracranial pathology, were randomized to receive either remifentanil/propofol (n=10) or sufentanil/propofol (n=10). A sedation score and a simplified pain score were used to assess adequate sedation and analgesia. Medication was temporarily stopped after 24 h. Immediately before and 10 and 30 min after, the degree of sedation and pain score were evaluated. Adequate analgesia and sedation was achieved with remifentanil 10.6 µg kg–1 h–1 and propofol 2.1 mg kg–1 h–1, or sufentanil 0.5 µg kg–1 h–1 and propofol 1.3 mg kg–1 h–1. The difference in propofol dose between groups was significant. Ten minutes after terminating the medication, the degree of sedation decreased significantly after remifentanil and all patients could follow simple commands. During the following 20 min, all patients with remifentanil emerged from sedation and complained of considerable pain. By contrast, in the sufentanil group, only six (7) responded to commands after 10 (30) min and their pain score remained essentially unchanged during the 30-min observation period. We conclude that, in contrast to sufentanil, remifentanil facilitates rapid emergence from analgesia and sedation, allowing a clinical neurological examination within 10–30 min in mechanically ventilated patients with no intracranial pathology.

Br J Anaesth 2001; 86: 763–8


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