Comparison of Intraoperative Infusion of Remifentanil Versus Fentanyl on Pain Management in Patients Undergoing Spine Surgery: A Double Blinded Randomized Clinical Trial

: Background: Remifentanil is an ultra-short-acting opioid which facilitates hemodynamic management. However, there are concerns about postoperative Remifentanil hyperalgesia because of it is potent, fast onset and offset. The aim of this study was to determine postoperative pain and visual Analogue Scale (VAS) and morphine consumption in two groups after spine surgery. Methods: In this randomized clinical trial study, 60 American Society of Anesthesiology (ASA) I-II patients aged between 18-60 years old who have undergone spine surgery were divided into two groups. In control group patients received 0.07-0.1 µg/kg/hr Fentanyl intra operatively and in the intervention group 0.1-0.2 µg/kg/min Remifentanil was infused during the surgery. Twenty minutes before the end of surgery both groups received 15 mg/kg intravenous Acetaminophen. Postoperative pain score and morphine consumption were measured in Post Anesthesia Care Unit (PACU), 6, 12, 24 and 48 hours after discharging from PACU. Results: During the first 12 hour VAS and morphine consumption were significantly higher in Remifentanil group (P < 0.001). During 12- 48 hour after surgery, there was no significant difference between two groups in morphine consumption. Conclusions: These findings suggest that Remifentanil infusion during surgery may increase postoperative pain. Also VAS and morphine consumption were higher during the first 12 hour.