Table 1 Characteristics of included studies

Cevik et al. [18]

Turkey

Single-center, open-label

September 2007 to May 2008

34

Patients requiring MV and sedation in the ICU

2

Fentanyl-midazolam regimen

Remifentanil-midazolam regimen

• Hemodynamic parameters

• Analgesics and sedative dosage

• Mean MV time^a

• Mean time to ICU discharge^a

• Organ dysfunction

• Adverse effect^a

Karabinis et al. [19]

Six countries in Europe (4 hospitals in Greece, 4 in Spain, 3 in Belgium, 3 in The Netherlands, 2 in Germany, 1 in Austria)

Multi-center, open-label

Not stated (published in 2004)

161

Acute, severe neurological insult or injury, or patients who had undergone elective or emergency neurosurgery

3

Hypnotic-based treatment (fentanyl)

Remifentanil-based treatment

• Median time on MV^a

• Extubation process

• Extubation to ICU discharge^a

• Serious adverse events^a

• Drug-related serious adverse events

• Mortality^a

Liu et al. [20]

China

Single-center, double-blind

September 2014 to January 2015

105

MV anticipated for > 24 h

3

Fentanyl

Remifentanil

• 28-day mortality^a

• Duration of MV^a

• Length of the ICU stay^a

• Delirium^a

• Duration of delirium

• Weaning time

Muellejans et al. [21]

Five countries, 21 centers (4 centers in Belgium, 8 in Germany, 1 in the Netherlands, 4 in Spain, 4 in the UK)

Multi-center, double-blind

Not stated (published in 2004)

152

MV for a further 12 to 72 h

2

Fentanyl

Remifentanil

• Extubation process – extubation^a

• Extubation – ICU discharge

• Drug start—ICU discharge^a

• Adverse events

• Drug-related adverse events

• MAP < 50 mmHg

• HR < 50 beats/min

• Severe adverse events^a

Muellejans et al. [22]

Germany

Single-center, open-label

Not stated (published in 2006)

80

MV for > 12 h

2

Hypnotic-based sedation with midazolam/fentanyl

Remifentanil-based analgesia and sedation with propofol

• Any adverse event

• Any serious adverse event^a

• Delirium^a

• Time from arrival in the ICU to extubation^a

• Time from arrival in the ICU to eligible ICU discharge^a

• Overall costs

Oliver et al. [23]

United States

Single-center, observer-blind

Not stated (published in 2011)

113

Scheduled elective cardiac surgery

3

Fentanyl and propofol

Morphine and propofol

• Time to extubation^a

• First response time

• Length of the ICU stay^a

• Length of the hospital stay

• ICU direct medical costs

Spies et al. [24]

Germany

Two-center, double-blind

December 2005 to June 2008

60

MV for > 24 h

2

Fentanyl

Remifentanil

• Proportion of patients who obtained the target analgesia score

• Duration of MV^a

• Duration of the ICU stay^a

• Duration of the hospital stay

• Delirium^a