• J. Hosp. Infect. · Jan 2015

    Remifentanil-based anaesthesia increases the incidence of postoperative surgical site infection.

    • T Inagi, M Suzuki, M Osumi, and H Bito.
    • Department of Anaesthesiology, Musashikosugi Hospital, Nippon Medical School, Kanagawa, Japan.
    • J. Hosp. Infect. 2015 Jan 1; 89 (1): 61-8.

    BackgroundSurgical site infection (SSI) after colorectal surgery is the leading cause of postoperative morbidity. Opioids induce immunosuppression through activation of μ-opioid receptors expressed on leucocytes, and through opioid withdrawal. A high dose of opioid administered as remifentanil during surgery may induce immunosuppression, leading to the development of SSI.AimThe purpose of this study was to investigate the influence of remifentanil on the development of SSI.MethodsAdult patients who underwent elective colorectal surgery from January 2009 to December 2012 (N = 286) were prospectively investigated according to the guidelines of the US Centers for Disease Control and Prevention. After exclusion of 51 patients, propensity matching was performed in 235 patients. To reduce the influence of selection on SSIs, propensity score pairwise matching was performed for patients maintained with remifentanil and for patients maintained with fentanyl.FindingsThe number of patients who developed SSI was higher after remifentanil-based anaesthesia compared with fentanyl-based anaesthesia [11.6% (17/146) vs 3.4% (3/89), remifentanil vs fentanyl, P = 0.03] before propensity matching. Propensity matching yielded 61 pairs of patients anaesthetized with remifentanil or fentanyl, and corrected several biases in the preoperative patient characteristics. After propensity matching, the number of patients who developed SSI was still higher after remifentanil-based anaesthesia than after fentanyl-based anaesthesia [16.4% (10/61) vs 3.3% (2/61), remifentanil vs fentanyl, P = 0.029].ConclusionRemifentanil-based anaesthesia increased the incidence of SSI. A possible reason may be opioid-induced immunosuppression or opioid withdrawal-induced immunosuppression.Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…