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Remifentanil

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https://www.readbyqxmd.com/read/28540470/effects-of-remifentanil-pretreatment-on-bupivacaine-cardiotoxicity-in-rats
#1
Özcan Pişkin, Hilal Ayoğlu
Unintentional intravascular administration of bupivacaine may cause local anesthetic systemic toxicity (LAST). Although many systems are affected in LAST, the cardiovascular effects can be life-threatening. Remifentanil is a selective, ultra-short-acting, µ-opioid receptor agonist opioid. This study assessed the effects of combined pretreatment with intravenous lipid emulsion (ILE) and remifentanil on the cardiotoxicity caused by bupivacaine in an experimental model of anesthetized rats. The rats were divided into three groups...
May 24, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#2
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28536526/dexmedetomidine-improves-postoperative-patient-controlled-analgesia-following-radical-mastectomy
#3
Wei Fan, Hong Xue, Yong Sun, HaiKou Yang, Jun Zhang, Guangming Li, Ying Zheng, Yi Liu
Acute postoperative pain following radical mastectomy is a high risk for prolonged convalescence and potential persistent pain in patients with breast cancer. The present study was designed to observe the effect of intraoperative use of dexmedetomidine on acute postoperative pain following radical mastectomy under general anesthesia. Forty-five patients were enrolled into the study and divided into two groups that were maintained with propofol/remifentanil/Ringer's solution or propofol/remifentanil/Dexmedetomidine followed by morphine-based patient-controlled analgesia...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28534702/factors-affecting-recovery-from-anaesthesia-with-propofol-remifentanil-target-controlled-infusion-in-laparoscopic-surgery
#4
Shao-Hua Liu, Ming Tian
Objective This study was performed to analyse factors influencing the effect-site concentration (Ce) of propofol at return of consciousness (ROC) with target-controlled infusion of propofol-remifentanil after laparoscopic surgery. Methods In total, 112 patients who underwent laparoscopic surgery under general anaesthesia were given propofol at the target concentration of 3.5 µg/ml. Remifentanil (Ce: 4.0 ng/ml) and 0.9 mg/kg of rocuronium were administered when the Observer's Assessment of Alertness/Sedation score reached 1...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28520577/the-effects-of-remifentanil-on-hemodynamic-response-attenuation-after-electroconvulsive-therapy-under-sevoflurane-anesthesia
#5
Feray Erdil, Ulku Ozgul, Mukadder Şanli, Gülay Kayhan, Cemil Çolak, Mahmut Durmuş
PURPOSE: We evaluated the effects of a single loading dose of remifentanil (1 μg/kg) administered as an adjunct to sevoflurane, on the duration of seizure activity, recovery times, and hemodynamic profiles, during electroconvulsive therapy. METHODS: The patients were randomly allocated to receive sevoflurane-saline (Group SS) or sevoflurane-remifentanil (Group SR). Sevoflurane (8%) was initiated for anesthesia induction in both groups until loss of consciousness was achieved...
May 18, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28509796/disposition-of-remifentanil-in-obesity-a-new-pharmacokinetic-model-incorporating-the-influence-of-body-mass
#6
Tae Kyun Kim, Shinju Obara, Talmage D Egan, Charles F Minto, Luca LaColla, David R Drover, Jaap Vuyk, Martijn Mertens
BACKGROUND: The influence of obesity on the pharmacokinetic (PK) behavior of remifentanil is incompletely understood. The aim of the current investigation was to develop a new population PK model for remifentanil that would adequately characterize the influence of body weight (among other covariates, e.g., age) on the disposition of remifentanil in the general adult population. We hypothesized that age and various indices of body mass would be important covariates in the new model. METHODS: Nine previously published data sets containing 4,455 blood concentration measurements from 229 subjects were merged...
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28509794/an-allometric-model-of-remifentanil-pharmacokinetics-and-pharmacodynamics
#7
Douglas J Eleveld, Johannes H Proost, Hugo Vereecke, Anthony R Absalom, Erik Olofsen, Jaap Vuyk, Michel M R F Struys
BACKGROUND: Pharmacokinetic and pharmacodynamic models are used to predict and explore drug infusion schemes and their resulting concentration profiles for clinical application. Our aim was to develop a pharmacokinetic-pharmacodynamic model for remifentanil that is accurate in patients with a wide range of age and weight. METHODS: Remifentanil pharmacokinetic data were obtained from three previously published studies of adults and children, one of which also contained pharmacodynamic data from adults...
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28509793/remifentanil-dosing-at-extremes-of-body-weight
#8
Steven L Shafer, Dennis M Fisher
No abstract text is available yet for this article.
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28494909/remifentanil-as-an-alternative-to-epidural-analgesia-for-vaginal-delivery-a-meta-analysis-of-randomized-trials
#9
Myeongjong Lee, Fang Zhu, Jessica Moodie, Zhe Zhang, Davy Cheng, Janet Martin
OBJECTIVES: Although epidural analgesia is considered the gold standard for labor pain management, its use may be restricted in some conditions due to clinical contraindications or availability, and suitable alternatives may be required. The objective of this meta-analysis was to determine whether evidence from randomized trials suggests remifentanil PCA (R-PCA) results in significant differences in maternal satisfaction, analgesic efficacy, and safety compared with conventional epidural analgesia (EA)...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28492294/effect-of-remifentanil-for-general-anaesthesia-on-parturients-and-newborns-undergoing-caesarean-section-a-meta-analysis
#10
Yunhui Zhang, Hongmei Lu, Zheng Fu, Huijun Zhang, Ye Li, Wei Li, Jingui Gao
BACKGROUND: The results presented by studies investigating the effect of remifentanil on both parturients and newborns during cesarean section differed significantly. Therefore, we performed a meta-analysis to estimate the effect of remifentanil on these patients. METHODS: Potentially eligible studies published before 15 March 2016 were searched through four databases including PubMed, SCOPUS, ISI web of knowledge and EBSCO. Weighted mean difference (WMD) or odds ratios (ORs) and the corresponding 95% confidence interval (CI) were applied to estimate the strength of relationship...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28489797/a-previously-published-propofol-remifentanil-response-surface-model-does-not-predict-patient-response-well-in-video-assisted-thoracic-surgery
#11
Hsin-Yi Wang, Chien-Kun Ting, Jing-Yang Liou, Kun-Hui Chen, Mei-Young Tsou, Wen-Kuei Chang
Modern anesthesia usually employs a hypnotic and an analgesic to produce synergistic sedation and analgesia. Two remifentanil-propofol interaction response surface models were used to predict sedation using Observer's Assessment of Alertness/Sedation (OAA/S) scores; one predicts an OAA/S <2 and the other <4. We hypothesized that both models would predict regained responsiveness (RR) after video-assisted thoracic surgery (VATS) to reduce total anesthesia time and make early extubation clinically relevant...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489642/pupillary-reflex-for-evaluation-of-thoracic-paravertebral-block-a-prospective-observational-feasibility-study
#12
Baptiste Duceau, Mélanie Baubillier, Gaëlle Bouroche, Aline Albi-Feldzer, Christian Jayr
BACKGROUND: Although thoracic paravertebral block (TPVB) is recommended in major breast surgery, there is no gold standard to assess the success of TPVB. Pupillary dilation reflex (PDR) is the variation of the pupillary diameter after a noxious stimulus. The objective was to evaluate the feasibility of recording the PDR to assess analgesia in an anesthetized thoracic dermatome after TPVB. METHODS: This prospective, observational, single-center study included 32 patients requiring breast surgery under general anesthesia and TPVB...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28489614/validation-of-innovative-techniques-for-monitoring-nociception-during-general-anesthesia-a-clinical-study-using-tetanic-and-intracutaneous-electrical-stimulation
#13
Sandra Funcke, Sven Sauerlaender, Hans O Pinnschmidt, Bernd C Saugel, Kai Bremer, Daniel A Reuter, Rainer Nitzschke
BACKGROUND: This study compares the analgesic indices Analgesia Nociception Index (heart rate variability), Surgical Pleth Index (photoplethysmography), and pupillary dilatation, to heart rate, mean arterial pressure, and bispectral index, with regard to diagnostic accuracy and prediction probability for nociceptive response. The primary endpoint was the correlation between Δ values and the remifentanil dose administered. METHODS: We anesthetized 38 patients with propofol and increasing doses of remifentanil and applied standardized tetanic and intracutaneous electrical painful stimulations on each analgesic level...
May 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28489210/sugammadex-ed90-dose-to-reverse-the-rocuronium-neuromuscular-blockade-in-obese-patients
#14
Mauro Prado DA Silva, Christiano Matsui, Daniel Dongiou Kim, Joaquim Edson Vieira, Carlos Alberto Malheiros, Ligia Andrade Silva Telles Mathias
Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28468670/the-effect-of-dexmedetomidine-on-cerebral-perfusion-and-oxygenation-in-healthy-piglets-with-normal-and-lowered-blood-pressure-anaesthetized-with-propofol-remifentanil-total-intravenous-anaesthesia
#15
Mai Louise Grandsgaard Mikkelsen, Rikard Ambrus, Rune Rasmussen, James Edward Miles, Helle Harding Poulsen, Finn Borgbjerg Moltke, Thomas Eriksen
BACKGROUND: During anaesthesia and surgery, in particular neurosurgery, preservation of cerebral perfusion and oxygenation (CPO) is essential for normal postoperative brain function. The isolated effects on CPO of either individual anaesthetic drugs or entire anaesthetic protocols are of importance in both clinical and research settings. Total intravenous anaesthesia (TIVA) with propofol and remifentanil is widely used in human neuroanaesthesia. In addition, dexmedetomidine is receiving increasing attention as an anaesthetic adjuvant in neurosurgical, intensive care, and paediatric patients...
May 3, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28458576/continuous-postoperative-infusion-of-remifentanil-inhibits-the-stress-responses-to-tracheal-extubation-of-patients-under-general-anesthesia
#16
Guoliang Zhao, Xiaoyue Yin, Ya Li, Jianlin Shao
PURPOSE: The study aimed to assess the combined effects of parecoxib with three different doses of remifentanil and its effect on the stress and cough responses following tracheal extubation under general anesthesia. METHODS: A total of 120 patients with American Society of Anesthesiologists (ASA) scores of I or II, undergoing selective thyroidectomy with total intravenous anesthesia (propofol-remifentanil) and tracheal intubation, were randomly allocated to be treated with an intravenous injection of parecoxib and a continuous infusion of remifentanil at 0...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28456848/range-of-s-100%C3%AE-levels-during-functional-endoscopic-sinus-surgery-with-moderately-controlled-hypotension
#17
Youngsuk Kwon, Ji Su Jang, Sung Mi Hwang, Jae Jun Lee, Jun Ho Lee, Sungmin Joo, In-Gon Lee, Sung Jun Hong
The aim of this study is to determine the range of S-100β levels during functional endoscopic sinus surgery (FESS) when the mean arterial pressure (MAP) was controlled within 60-70 mmHg. After anesthesia induction with propofol and remifentanil, the patient was positioned in the reverse Trendelenburg position and MAP was controlled within 60-70 mmHg during surgery. For the S-100β assay, blood was taken from a radial arterial catheter before (baseline) and at 20 (T 20) and 60 (T 60) min after setting the reverse Trendelenburg position and controlled hypotension, and at 60 (T post60) min after the end of the operation...
April 29, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28456442/preliminary-investigation-of-preoperative-pregabalin-and-total-intravenous-anesthesia-doses-a-randomized-controlled-trial
#18
Mine Altınkaya Chavush, Seyhan Yağar, Ayşim Ertürk, Ayşegül Özgök
STUDY OBJECTIVE: To determine the efficacy of 2 different doses (150-300mg) of preoperative pregabalin on propofol and remifentanil doses for total intravenous anesthesia in laparoscopic cholecystectomy. DESIGN: Prospective, randomized, placebo-controlled, double-blinded study. SETTING: Training and research hospital. PATIENTS: Forty-eight adult, American Society of Anesthesiologists physical status 1 and 2 patients...
April 26, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28450928/effect-of-etomidate-on-the-oxidative-stress-response-and-levels-of-inflammatory-factors-from-ischemia-reperfusion-injury-after-tibial-fracture-surgery
#19
Renke Li, Lei Fan, Fenglei Ma, Yongyan Cao, Junwei Gao, Huawen Liu, Yan Li
The effect of etomidate on the oxidative stress response and levels of inflammatory factors resulting from ischemia-reperfusion injury of the lower extremities during tibial fracture surgery were investigated. From December 2013 to June 2015, 60 tibial fracture patients with surgical indications for open reduction and internal fixation were selected. Patients were randomly divided into the observation group and the control group. All patients were stanched by tourniquet hemostasis. Patients in the observation group were anesthetized with etomidate (3-6 mg/kg·h) + remifentanil (0...
March 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28449630/sevoflurane-at-1-0-mac-together-with-remifentanil-and-propofol-produces-clinically-acceptable-intubation-conditions-at-the-vocal-cords-a-prospective-randomized-study
#20
Attila Ovari, Ilona Bicker, Susann Machmueller, Tobias Schuldt, Martin Sauer, Stefan Soltesz, Gabriele Noeldge-Schomburg, Robert Mlynski, Thomas Mencke
Objective The overall intubation conditions after tracheal intubation with remifentanil, propofol, and sevoflurane at 1.0 minimum alveolar concentration (MAC) are worse than with rocuronium at 0.45 mg/kg. Therefore, we compared the intubation conditions and laryngeal morbidity (vocal cord injuries, hoarseness, and sore throat) with sevoflurane at 1.2 and 1.4 MAC versus 1.0 MAC. Methods In this prospective clinical trial, 90 patients were randomized to 3 groups: the sevoflurane 1.0, 1.2, and 1.4 MAC groups...
January 1, 2017: Journal of International Medical Research
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