Low-dose remifentanil as an adjunct analgesic is not associated with clinically important opioid-induced hyperalgesia: secondary analysis from a randomized controlled trial
Authors' conclusion
Opioid-induced hyperalgesia and increased opioid requirement after low-dose remifentanil use is unlikely to be clinically significant.
Study context
- Population
- Patients undergoing same-day surgeries
- Participants
- 276 vs 126
- Comparison
- R vs C
- Rn = 276
- Cn = 126reference
- Primary endpoint
- Pain scores in the PACU and 24 hours after surgery
Methodological detailssecondary analysis
- Secondary analysis
Primary result
As reported in the abstract
R vs CMean difference (95% CI)
Average pain scores 24 hours after surgery
0.4(−1.7 to 0.9)
- Maximum PACU pain scores
- mean difference 0.3 (95% CI −0.9 to 0.2)
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Dose of long-acting opioids in PACU (IV morphine equivalents)Higher in the R group | mean difference 0.97 mg (95% CI 0.2–1.7) | P = 0.01 | |
| Long-acting opioid doses in PACU per 25 mcg remifentanil increment (adjusted; IV morphine equivalents)Adjusted analyses | adjusted increase per 25 mcg 0.14 mg (95% CI 0.02–0.25) | P = 0.02 | |
| −1012Difference, mg (linear scale) |
| Outcome | Adjusted increase per 25 mcg (units) (95% CI) | P value | |
|---|---|---|---|
| Maximum pain scores in day surgical unit per 25 mcg remifentanil increment (adjusted)Adjusted analyses | 0.23 (0.05–0.41) | P = 0.01 | |
| Average pain scores 24 hours after surgery per 25 mcg remifentanil increment (adjusted)Adjusted analyses | 0.25 (0.036–0.46) | P = 0.02 | |
| −0.200.20.40.6Difference, units (linear scale) |
Original publication
Low-dose remifentanil as an adjunct analgesic is not associated with clinically important opioid-induced hyperalgesia: secondary analysis from a randomized controlled trial. Reg Anesth Pain Med. Published 24 April 2025. doi:10.
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