Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries – A systematic review

Background and Aims: Obese patients undergoing bariatric and metabolic surgeries have a high chance of respiratory depression and could need admission to an intensive care unit or a high-dependency unit. Several studies have compared remifentanil to other opioids or non-opioids in these patients. Th...

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Main Authors: Abhijit S. Nair, Indira Gurajala, Nitinkumar Borkar, Ujjwalraj Dudhedia, Manamohan Rangaiah, Sandeep Diwan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Indian Journal of Anaesthesia
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Online Access:https://journals.lww.com/10.4103/ija.ija_825_24
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author Abhijit S. Nair
Indira Gurajala
Nitinkumar Borkar
Ujjwalraj Dudhedia
Manamohan Rangaiah
Sandeep Diwan
author_facet Abhijit S. Nair
Indira Gurajala
Nitinkumar Borkar
Ujjwalraj Dudhedia
Manamohan Rangaiah
Sandeep Diwan
author_sort Abhijit S. Nair
collection DOAJ
description Background and Aims: Obese patients undergoing bariatric and metabolic surgeries have a high chance of respiratory depression and could need admission to an intensive care unit or a high-dependency unit. Several studies have compared remifentanil to other opioids or non-opioids in these patients. This review investigated the efficacy and safety of remifentanil in bariatric and metabolic surgeries. Methods: After registering with PROSPERO, we searched PubMed/Medline, Ovid, CINAHL and the Cochrane Library with relevant keywords to find studies in which remifentanil was compared to other opioids or non-opioids in adult patients undergoing bariatric and metabolic surgeries. We used the risk of bias-2 tool to assess bias and Grading of Recommendation, Assessment, Development and Evaluation to determine the level of evidence. RevMan 5.4 was used to perform a quantitative meta-analysis. Results: Of the 121 articles retrieved from the database search, seven articles fulfilled the inclusion criteria. The overall bias was low in five studies and high in two studies. There was significant heterogeneity in the control group, which comprised opioids and also non-opioids like labetalol, dexmedetomidine and lignocaine. A quantitative meta-analysis was not reported due to a lack of comparable data for a meaningful quantitative meta-analysis. Conclusion: The results of this systematic review neither support nor refute the use of remifentanil in patients undergoing bariatric and metabolic surgeries, compared to other medications. Further studies are needed to investigate its efficacy and safety in these patients.
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spelling doaj-art-8284477038b9490fbf93fe8a87b172742025-02-06T05:26:09ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172025-01-0169112313110.4103/ija.ija_825_24Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries – A systematic reviewAbhijit S. NairIndira GurajalaNitinkumar BorkarUjjwalraj DudhediaManamohan RangaiahSandeep DiwanBackground and Aims: Obese patients undergoing bariatric and metabolic surgeries have a high chance of respiratory depression and could need admission to an intensive care unit or a high-dependency unit. Several studies have compared remifentanil to other opioids or non-opioids in these patients. This review investigated the efficacy and safety of remifentanil in bariatric and metabolic surgeries. Methods: After registering with PROSPERO, we searched PubMed/Medline, Ovid, CINAHL and the Cochrane Library with relevant keywords to find studies in which remifentanil was compared to other opioids or non-opioids in adult patients undergoing bariatric and metabolic surgeries. We used the risk of bias-2 tool to assess bias and Grading of Recommendation, Assessment, Development and Evaluation to determine the level of evidence. RevMan 5.4 was used to perform a quantitative meta-analysis. Results: Of the 121 articles retrieved from the database search, seven articles fulfilled the inclusion criteria. The overall bias was low in five studies and high in two studies. There was significant heterogeneity in the control group, which comprised opioids and also non-opioids like labetalol, dexmedetomidine and lignocaine. A quantitative meta-analysis was not reported due to a lack of comparable data for a meaningful quantitative meta-analysis. Conclusion: The results of this systematic review neither support nor refute the use of remifentanil in patients undergoing bariatric and metabolic surgeries, compared to other medications. Further studies are needed to investigate its efficacy and safety in these patients.https://journals.lww.com/10.4103/ija.ija_825_24acute painanaesthesiabariatric surgerymeta-analysismetabolic surgeryopioidsremifentanilsystematic review
spellingShingle Abhijit S. Nair
Indira Gurajala
Nitinkumar Borkar
Ujjwalraj Dudhedia
Manamohan Rangaiah
Sandeep Diwan
Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries – A systematic review
Indian Journal of Anaesthesia
acute pain
anaesthesia
bariatric surgery
meta-analysis
metabolic surgery
opioids
remifentanil
systematic review
title Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries – A systematic review
title_full Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries – A systematic review
title_fullStr Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries – A systematic review
title_full_unstemmed Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries – A systematic review
title_short Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries – A systematic review
title_sort safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries a systematic review
topic acute pain
anaesthesia
bariatric surgery
meta-analysis
metabolic surgery
opioids
remifentanil
systematic review
url https://journals.lww.com/10.4103/ija.ija_825_24
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