• Ann Fr Anesth Reanim · Dec 2007

    Randomized Controlled Trial Comparative Study

    [Daily interruption of sedation in intensive care unit patients with renal impairment: remifentanil-midazolam compared to fentanyl-midazolam].

    • M Belhadj Amor, R Ouezini, K Lamine, M Barakette, I Labbène, and M Ferjani.
    • Service d'anesthésie-réanimation, hôpital militaire principal d'instruction de Tunis, 1008 Tunis, Tunisie. mondherbenhaj@yahoo.fr
    • Ann Fr Anesth Reanim. 2007 Dec 1;26(12):1041-4.

    ObjectiveWe compared extubation time following daily interruption of sedation in intensive care unit patients with renal impairment with two sedation regimes remifentanil-midazolam and fentanyl-midazolam.Study DesignProspective, randomized double-blind trial.Patients And MethodsPatients with renal impairment needing mechanical ventilation for more than 48 hours. Two groups: remifentanil (R) and fentanyl (F), Infusion rates were titrated to achieve the desired Ramsay score. The two groups received midazolam (2.5 mg then 0.1 mg/kg/h).ResultsNineteen patients were included. Patient's characteristics, mean sedation time and sedation quality were comparable. Extubation time was significantly shorter in R group (1480+/-980 versus 2880+/-1280 min, P=0.04). Weaning time was also shorter in R group (220+/-164 versus 720+/-480 min). Agitation on weaning was comparable in the two groups. Group R received significantly more morphine than group F after interruption of sedation.ConclusionDaily interruption of sedation with remifentanil is associated with shorter weaning and extubation time in patients with renal impairment. However further studies are necessary to determine if this issue is associated with lower rate of ventilation induced complications.

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