• Seyed Mostafa Alavi, Seyed Mohammadmehran Ghoreishi, Mitra Chitsazan, Iman Ghandi, Alireza Jahangiri Fard, Seyed Saeed Hosseini, Maziar Mahjoobifard, and Kamal Fani.
• Department of Cardiac Anesthesiology, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
• Asian Cardiovasc Thorac Ann. 2014 Jul 1; 22 (6): 694-9.

Backgroundadequate pain control after cardiac surgery is mandatory to reduce its remarkable morbidity. In this study, we aimed to compare the efficacy of patient-controlled analgesia with remifentanil or sufentanil for pain management after coronary artery bypass grafting.Methods249 patients who underwent coronary artery bypass were randomly assigned to receive patient-controlled analgesia with remifentanil or sufentanil during the first 24 h postoperatively. Pain intensity during patient-controlled analgesia was assessed using 4 different pain rating scales.Resultspatients given remifentanil had lower Visual Analog Scale scores at 24 h compared to those given sufentanil (p = 0.002). The Numeric Rating Scale at 24 h was also significantly lower in patients using remifentanil (p = 0.004). The Faces Pain Scale scores at 4, 18, and 24 h were significantly lower in patients using remifentanil compared to those using sufentanil (p = 0.045, 0.036, and 0.011, respectively). No significant differences between groups were seen in the pain intensity assessed by the Behavior Rating Scale at any time point during the first 24 h postoperatively.Conclusionour study showed that both remifentanil and sufentanil patient-controlled analgesia can provide acceptable analgesia after coronary artery bypass. The difference between their efficacies was inconspicuous until 24 h postoperatively. Remifentanil seems to result in better pain relief at 24 h postoperatively.© The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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