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Abstract
Remifentanil is ultra-short acting opioid with constant context-sensitive half time and can be used during general anesthesia and in sedation in ICU without fear of accumulation. The aim of the present study is to compare remifentanil and fentanyl in providing analgesia based sedation in post-operative short-term mechanically ventilated patients. Sixty patients undergoing major abdominal surgery were studied and randomly allocated to receive six hours continuous analgesia by either remifentanil (30 patients) or fentanyl (30 patients) and propofol was added only when required to both groups. The present study showed that remifentanil as effective as fentanyl and there were no statistically difference between the two groups as regarding quality of pain control, sedation level, and recovery from the drugs, haemodynamic stability, respiratory parameters, or laboratory findings. Despite the fact that remifentanil is ultra-short acting, the recovery parameters ware statistically insignificant. So, successful management of analgesia and sedation did not depend on the choice of suitable drugs only but also other factors are also important. These factors includes: non-pharmacological approach, use protocols to give analgesics and sedatives, concentrate on pain management first (analgesia based sedation) and frequent assessment of pain and anxiety and subsequent adjustment of analgesics and sedatives