Remifentanil

Wilhelm, Wolfram; Wrobel, Marc; Kreuer, Sascha; Larsen, Reinhard

doi:10.1007/s00101-003-0540-9

Cited by 50 publications

(7 citation statements)

References 71 publications

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“…Es gibt vereinzelte Berichte über die Anwendung von Remifentanil bei extubierten Intensivpatienten. Zu beachten ist dabei jedoch die erhöhte Rate an Apnoen oder Bradypnoen [71].…”

Section: Verbandwechselunclassified

“…Es gibt vereinzelte Berichte über die Anwendung von Remifentanil bei extubierten Intensivpatienten. Zu beachten ist dabei jedoch die erhöhte Rate an Apnoen oder Bradypnoen [71]. Wird eine Remifentanilinfusion zur Analgesie bei nichtbeatmeten Intensivpatienten eingesetzt, so müssen die Patienten aufgrund der hohen Wirksamkeit der Substanz pausenlos (!)…”

Section: Analgosedierung Zum Verbandwechsel Nichtbeatmeter Patienten unclassified

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Das Verbrennungstrauma –Teil 2

2009

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After initial stabilization of burn victims at the scene and in the trauma room, a tight cooperation and communication between anesthesiologists, plastic surgeons and intensive care specialists is needed for further therapy. Interdisciplinary communication about preoperative planning, timing of necrectomy and intensive care therapy is vital regarding functional and aesthetic outcome and survival rate. During burn surgery attention has to be paid to excessive blood loss and the danger of hypothermia. The main problems of intensive care therapy involve the evaluation of volume status, high demands for analgesia and sedation, high incidence of septic multiorgan failure and therapy and prophylaxis of the effects of hypermetabolism.

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“…Es gibt vereinzelte Berichte über die Anwendung von Remifentanil bei extubierten Intensivpatienten. Zu beachten ist dabei jedoch die erhöhte Rate an Apnoen oder Bradypnoen [71].…”

Section: Verbandwechselunclassified

Section: Analgosedierung Zum Verbandwechsel Nichtbeatmeter Patienten unclassified

Das Verbrennungstrauma –Teil 2

2009

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“…Dies gilt auch für Patienten mit angeborenem Pseudocholinesterasemangel oder bei konkurrierender Situation mit anderen Substanzen, die ebenfalls durch Plasmaesterasen abgebaut werden (z. B. Esmolol; [54]). Gleichzeitig ist bei Patienten mit Nierenerkrankungen keine Dosisanpassung notwendig [24].…”

Section: Abrupter Analgesieverlustunclassified

Intraoperative Remifentanilgabe und postoperative Schmerztherapie

Zöllner

Schäfer

2007

Anaesthesist

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Remifentanil is a synthetic opioid derivate with an agonist activity at mu-opioid receptors. The pharmacokinetic profile differs from other synthetic opioids. Remifentanil is rapidly metabolised by unspecific blood and tissue esterases and the metabolites have almost no intrinsic activity. According to its unique pharmacokinetic profile, remifentanil-based anaesthesia might be associated with a high level of postoperative pain, therefore, an appropriate postoperative pain management is an import aspect. In addition, remifentanil withdrawal induces a compensatory up-regulation of secondary messenger pathways, inducing hyperalgesia. This review provides a comprehensive summary of basic and clinical research concerning the intraoperative use of remifentanil and postoperative pain therapy. The relative contribution of rapid degradation and withdrawal-induced hyperalgesia to postoperative pain will be discussed. In addition, this review attempts to identify potential clinical implications and treatment strategies.

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“…Diese moderne große "monitored anesthesia care" ("Big MAC") zielt auf eine ressourcenschonende "Fasttrack"-Anästhesie mit möglichst kurzen Aufwach-, Wechsel-, Übergabe-und Aufwachraumzeiten ("PACU"), ohne dabei Sicherheit und Patientenkomfort zu kompromittieren [30,36,37].…”

Section: Abb 6 ▲ Vergleich Der Schmerzangaben Von Männern Und Frauenunclassified

Die Ureterorenoskopie in Analgosedierung

2004

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In a prospective study, from September 2000 to September 2001, all ureteroscopies ( n=140) were performed under local and intravenous patient controlled analgesia using continuous infusion of remifentanil (Ultiva). The dosage of 0.15 micro g/kg/min was adapted to changing intraoperative pain (range 0.08-0.30 micro g/kg/min). Preoperative sedation with midazolam 2 mg was given 5 min prior to ureteroscopy. The efficacy of monitored anesthesia care ("Big MAC") was quantified by the patient using a visual analogue pain scale. A total of 97.1% (136/140) of the procedures were performed and finished under remifentanil. Only four male patients underwent conversion to general anesthesia due to insufficient analgesia. All but one patient would choose remifentanil again for first line anesthesia. Significant differences in pain scale values were noticed for male/female patients and ureteroscopies above/below the iliac vessel crossing. Side effects were rare being mainly hypoxic events (pO(2)<90% in 5.1%). Indication, intraoperative procedure, average surgery time (24 min), complications and primary success rate (96.6/90/63.3% stone free for distal/mid/proximal ureter, respectively) did not differ from the control group under general anesthesia. Ureteroscopies with remifentanil are safe, universally applicable because of refifentanil's organ independent esterase metabolism and as effective as general anesthesia. There is no need for PACU stay for patients due to the ultra-short drug half-life, and therefore remifentanil is cost effective and perfect in an outpatient setting.

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Remifentanil

Cited by 50 publications

References 71 publications

Das Verbrennungstrauma –Teil 2

Das Verbrennungstrauma –Teil 2

Intraoperative Remifentanilgabe und postoperative Schmerztherapie

Die Ureterorenoskopie in Analgosedierung

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