Bibliographic record
Abstract
Background and aims: The pharmacological properties of remifentanil make it an attractive medication in the anesthetic care of children undergoing cardiac surgery. Remifentanil has been reported to induce post-operative hyperalgesia. We hypothesized that children who had received remifentanil during cardiac surgery would require more sedative and analgesic agents post-operatively than those who had not. Aims: Compare total analgesic and sedative administration (mg/kg) between Remifentanil and no-Remifentanil groups for the first 48 post-operative hours. Secondary outcomes were number of sedative or analgesic bolus medications administered and the mean analgesic and sedative administration (mg/kg/hr) for the first 48 post-operative hours. Methods: Retrospective inception cohort review of children (age 40 weeks cGA to 12 years) who underwent cardiac surgery requiring cardiopulmonary bypass from 2004 to 2008. IRB approved study with waived consent. Results: Of 184 patients, 70 received remifentanil. Patients in the no-remifentanil group had longer durations of cardiopulmonary bypass (p=0.0014), more complex cardiac lesions (higher RACHS-1 score, P=0.051), and longer aortic cross clamp times (p=0.015). After statistical adjustment, the total dose of analgesic (morphine p=0.48; fentanyl p=0.23) and sedative (midazolam p=0.50; lorazepam p=0.97) was not significantly different, though the median total dose of morphine-equivalent opioids was higher in the no-remifentanil group (p=0.04). There was no difference between in the mean number of bolus doses of sedative and analgesic medications (remifentanil group 15.0 [95% CI 11.9–18.1] versus no-remifentanil group 14.6 [95% CI 12.6–16.6], p=0.81), and mean 48-hour drug administration was similar (morphine p=0.92, fentanyl p=0.33, midazolam p=0.69). Conclusions: Intra-operative use of remifentanil did not result in increased post-operative sedation or analgesic requirements.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.748 | 0.647 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".