Hasan, M. Shahnaz and Razak, Norashekeen Abdul and Yip, Hing Wa and Lee, Zheng-Yii and Chan, Chris Yin Wei and Kwan, Mun Keong and Chiu, Chee Kidd and Yunus, Siti Nadzrah and Ng, Ching Choe (2023) Association between intraoperative remifentanil use and postoperative hyperalgesia in adolescent idiopathic scoliosis surgery: A retrospective study. BMC Anesthesiology, 23 (1). ISSN 1471-2253, DOI https://doi.org/10.1186/s12871-023-02127-8.
Full text not available from this repository.Abstract
BackgroundThe liberal use of remifentanil in spine surgery has been associated with an increased incidence of postoperative hyperalgesia. Nevertheless, controversies remain as the existing evidence is inconclusive to determine the relationship between remifentanil use and the development of opioid-induced hyperalgesia. We hypothesized that intraoperative infusion of higher dose remifentanil during scoliosis surgery is associated with postoperative hyperalgesia, manifesting clinically as greater postoperative morphine consumption and pain scores.MethodsNinety-seven patients with adolescent idiopathic scoliosis (AIS) who underwent posterior spinal fusion surgery at a single tertiary institution from March 2019 until June 2020 were enrolled in this retrospective study. Anesthesia was maintained using a target-controlled infusion of remifentanil combined with volatile anesthetic desflurane in 92 patients, while five patients received it as part of total intravenous anesthesia. Intravenous ketamine, paracetamol, and fentanyl were administered as multimodal analgesia. All patients received patient-controlled analgesia (PCA) morphine postoperatively. Pain scores at rest and on movement, assessed using the numerical rating scale, and the cumulative PCA morphine consumption were collected at a six-hourly interval for up to 48 h. According to the median intraoperative remifentanil dose usage of 0.215 mu g/kg/min, patients were divided into two groups: low dose and high dose group.ResultsThere were no significant differences in the pain score and cumulative PCA morphine consumption between the low and high dose remifentanil group. The mean duration of remifentanil infusion was 134.9 +/- 22.0 and 123.4 +/- 23.7 min, respectively.ConclusionIntraoperative use of remifentanil as an adjuvant in AIS patients undergoing posterior spinal fusion surgery was not associated with postoperative hyperalgesia.
| Item Type: | Article |
|---|---|
| Funders: | Faculty of Medicine, University of Malaya [Grant No: GPF002-2020] |
| Uncontrolled Keywords: | Opioid; Remifentanil; Pain; Postoperative; Hyperalgesia; Scoliosis; Adolescent |
| Subjects: | R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 07 Oct 2025 01:45 |
| Last Modified: | 07 Oct 2025 01:45 |
| URI: | http://eprints.um.edu.my/id/eprint/48269 |
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