A Comparison of Remifentanil and Sufentanil as Adjuvants During Sevoflurane Anesthesia with Epidural Analgesia for Upper Abdominal Surgery: Effects on Postoperative Recovery and Respiratory Function

Casati, Andrea; Albertin, A.; Fanelli, Guido; Deni, Francesco; Berti, Marco; Danelli, G.; Grifoni, Federica Irene; Torri, G.

doi:10.1213/00000539-200011000-00040

Cited by 5 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…................................................................................................................................................................................................................ [8,23,24,32,33,57,70,73,79,87,89,95,100], cumulative occurrence of rigidity was not significantly higher (3.5%) than when it was administered at slower rates (2.9%) [27,81,86]. Accordingly, in the dose range of the included studies, remifentanil did not cause a clinically significant increase in rigidity compared with the other opioids, even when a bolus dose was employed.…”

Section: Resultsmentioning

confidence: 99%

Remifentanil for general anaesthesia: a systematic review

et al. 2007

View full text Add to dashboard Cite

SummaryWe performed a quantitative systematic review of randomised, controlled trials that compared remifentanil to short-acting opioids (fentanyl, alfentanil, or sufentanil) for general anaesthesia. Eighty-five trials were identified and these included a total of 13 057 patients. Intra-operatively, remifentanil was associated with clinical signs of deeper analgesia and anaesthesia, such as fewer responses to noxious stimuli (relative risk 0.65, 95% CI 0.48-0.87), more frequent episodes of bradycardia (1.46, 1.04-2.05), more hypotension (1.68, 1.36-2.07) and less hypertension (0.60, 0.46-0.78). Postoperatively, remifentanil was associated with faster recovery (difference in extubation time of )2.03, 9.5% CI, )2.92 to

show abstract

Section: Resultsmentioning

confidence: 99%

Remifentanil for general anaesthesia: a systematic review

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Low-flow anesthesia reduces sevoflurane gas consumption [1] . It has been demonstrated that even small doses of remifentanil added to volatile anesthetics to implement analgesia result in a marked reduction of the end-tidal concentration of the volatile agent required to control stress responses induced by surgical stimulation [5] , accelerating postoperative recovery and minimizing opioid-related depressant effects on respiratory function postoperatively [11] . Sevoflurane is often used in combination with remifentanil as both drugs have been reported to enable rapid emergence and awakening [12] .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Recovery and Anesthetic Gas Consumption Using Remifentanil Combined with Low-Flow Sevoflurane Anesthesia in Tympanoplasty

Sert

Muslu²,

Gözdemir³

et al. 2011

ORL

View full text Add to dashboard Cite

Background: The aim of this study was to compare the effects of low-flow sevoflurane and low-flow sevoflurane supplemented with remifentanil anesthesia on the recovery time, consumption amount of the anesthetic drugs and hemodynamic differences. Materials and Methods: A prospective, randomized and double-blinded study with 50 patients was designed. Following intubation, group S received sevoflurane 1.8 vol%, oxygen, nitrous oxide at 4 l · min^–1 and normal saline continuous infusion; group SR received sevoflurane 1.2 vol%, oxygen, nitrous oxide at 4 l · min^–1 and 0.25 µg · kg^–1 · min^–1 remifentanil continuous infusions. Ten minutes after intubation the flow rates decreased to 1 l · min^–1. Consumption of each drug, postoperative recovery characteristics and visual analog scale (VAS) scores for pain were recorded. Result: There were no significant differences in hemodynamic parameters, tramadol consumption and VAS scores for pain. The patients in group SR showed faster early recovery as compared to group S. The mean consumption of sevoflurane was 18 ml in group SR, while it was 25 ml in group S. Conclusions: Low-flow sevoflurane anesthesia combined with remifentanil regimen in patients undergoing tympanoplasty surgery resulted in a faster early recovery and decreased sevoflurane consumption.

show abstract

“…In upper intra-abdominal surgery, a degree of postoperative respiratory impairment directly related to surgery is also present, and an effective postoperative analgesia is readily provided by central blockade. In this situation, remifentanil provides shorter time to extubation and fewer effects on postoperative SpO 2 than sufentanil in the first 7 h after surgery (Casati et al 2000).…”

Section: Absence Of Residual Opioid Effect: An Advantage or A Drawback?mentioning

confidence: 99%

“…with a regional technique). Clinically, remifentanil titratability translates into a better control over adrenergic stimuli whatever the type of surgery or the patients (Kapila et al 1995;Mouren et al 2001;Schuttler et al 1997;Cartwright et al 1997;Gemma et al 2002;Guy et al 1997;Howie et al 2001;McGregor et al 1998;Sneyd et al 2001;Ahonen et al 2000;Balakrishnan et al 2000;Casati et al 2000;Doyle et al 2001;Fleisher et al 2001;Natalini et al 1999;Twersky et al 2001;Wee et al 1999;Wilhelm et al 2001). For example, intubation is a stronger stimulus than laryngoscopy, which in turn is stronger than skin incision.…”

Section: Control Over Intra-operative Stimulimentioning

confidence: 99%

See 1 more Smart Citation

Remifentanil and Other Opioids

Servin

Billard

Handbook of Experimental Pharmacology

View full text Add to dashboard Cite

Most opioids used in anaesthesia are of the anilidopiperidine family, including fentanyl, alfentanil, sufentanil and remifentanil. While all share similar pharmacological properties, remifentanil, the newest one, is probably the most original, which is the reason this review focusses especially on this drug. Remifentanil is a potent mu-agonist that retains all the pharmacodynamic characteristics of its class (regarding analgesia, respiratory depression, muscle rigidity, nausea and vomiting, pruritus, etc.) but with a unique pharmacokinetic profile that combines a short onset and the fastest offset, independent of the infusion duration. Consequently, it offers a unique titratability when its effects need to be quickly achieved or suppressed, but it requires specific drug delivery schemes such as continuous infusion, target-controlled infusion and anticipated postoperative pain treatment. Kinetic differences between opioids used in anaesthesia and some clinical uses of remifentanil are reviewed in this chapter.

show abstract

A Comparison of Remifentanil and Sufentanil as Adjuvants During Sevoflurane Anesthesia with Epidural Analgesia for Upper Abdominal Surgery: Effects on Postoperative Recovery and Respiratory Function

Cited by 5 publications

References 16 publications

Remifentanil for general anaesthesia: a systematic review

Remifentanil for general anaesthesia: a systematic review

Evaluation of Recovery and Anesthetic Gas Consumption Using Remifentanil Combined with Low-Flow Sevoflurane Anesthesia in Tympanoplasty

Remifentanil and Other Opioids

Contact Info

Product

Resources

About