Remifentanil as a Single Drug for Extracorporeal Shock Wave Lithotripsy: A Comparison of Infusion Doses in Terms of Analgesic Potency and Side Effects

Medina, Hector J.; Galvin, Eilish M.; Dirckx, Maaike; Banwarie, Preveen; Ubben, Johannes F. H.; Zijlstra, Freek J.; Klein, Jan; Verbrugge, Serge

doi:10.1213/01.ane.0000159379.54705.84

Cited by 34 publications

(28 citation statements)

References 19 publications

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“…[8] It has been shown that a lower basal remifentanil infusion rate decreases the side effects of treatment (nausea, vomiting, itching and dizziness) with no difference in VAS compared to a higher infusion rate. [9] A bolus delivery with no basal infusion dose may lead to a faster recovery with no change in patient comfort or overall satisfaction. [10] In our study, we did not administer a basal infusion and provided a bolus dose, with dose escalation as required.…”

Section: Discussionmentioning

confidence: 99%

Remifentanil patient controlled analgesia for patients unable to tolerate lithotripsy with enteral analgesia

Henderson¹,

Jones²,

O'Neill³

et al. 2013

J Anesthesiol Clin Sci

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Background: Extracorporeal shock wave lithotripsy is an effective treatment for kidney stones which does not require general anaesthesia and can be performed as a daycase procedure. The fragmentation of calculi can be painful and various analgesic regimens have been described. A small minority of our patients are unable to tolerate ESWL with enteral analgesia. We offered a repeat ESWL treatment with remifentanil Patient Controlled Analgesia (R-PCA) to this group.

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Section: Discussionmentioning

confidence: 99%

Remifentanil patient controlled analgesia for patients unable to tolerate lithotripsy with enteral analgesia

Henderson¹,

Jones²,

O'Neill³

et al. 2013

J Anesthesiol Clin Sci

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“…No se recomienda su uso en embarazadas, durante la lactancia ni en menores de 2 años. Hasta en el 9% de los pacientes puede haber rigidez muscular, pero esta se reduce a 1% cuando se usa junto con un hipnótico potente o con un relajante muscular, esto en el escenario de la anestesia general o en el uso de infusión continua (34,39,41,42).…”

Section: Eficienciaunclassified

Seguridad y eficiencia de sedación balanceada con propofol y remifentanil en endoscopia digestiva alta diagnóstica. Una experiencia exitosa

Avellaneda¹,

García²,

Avellaneda³

et al. 2017

Rev. Colomb. Gastroenterol.

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La sedación es una técnica anestésica de amplia utilización en los procedimientos endoscópicos digestivos actuales dado su claro beneficio en la tolerancia y comodidad para el paciente y el endoscopista. El medicamento de mayor uso en la actualidad para utilizarse como monosedación es el Propofol, pero los esquemas balanceados utilizando más de un medicamento ahora son ampliamente usados en endoscopia diagnóstica o terapéutica. La sedación balanceada utilizando Propofol y Remifentanil permite la potenciación sinérgica de un sedante con un opioide de ultra corta acción, lo que a su vez favorece la disminución respectiva de cada dosis. Se presenta una serie de 1148 pacientes llevados a endoscopia digestiva alta diagnóstica con dosis promedio de Remifentanil de 0,9 mcg/kg de peso, y de Propofol de 0,47mg/kg de peso, sin eventos adversos graves, con excelente satisfacción para el endoscopista y con muy bajo costo de la dosis por medicamento, con lo que se infiere ser un esquema seguro y eficiente.

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“…Es konnte gezeigt werden, dass die Verwendung von Remifentanil in niedriger Dosierung (bis 0,3 μg/kg-KG/min) eine ausreichende Analgesie bei Zahnextraktionen [20], Knochenmarkpunktionen [7], fiberoptischen Bronchoskopien [9], Endoskopien und Biopsien [36] bieten kann. Nach Abschluss der Intervention und der kontinuierlichen Remifentanilapplikation war in den genannten Studien in der Mehrheit der Fäl-le keine postoperative Schmerztherapie erforderlich [7,9,20,36,40]. Es kann jedoch nicht ausgeschlossen werden, dass es auch bei diagnostischen Untersuchungen oder Interventionen zu starken Schmerzen nach Beendigung einer Intervention kommen kann.…”

Section: Kurzeingriffe Und Diagnostische Untersuchungenunclassified

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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Remifentanil as a Single Drug for Extracorporeal Shock Wave Lithotripsy: A Comparison of Infusion Doses in Terms of Analgesic Potency and Side Effects

Cited by 34 publications

References 19 publications

Remifentanil patient controlled analgesia for patients unable to tolerate lithotripsy with enteral analgesia

Remifentanil patient controlled analgesia for patients unable to tolerate lithotripsy with enteral analgesia

Seguridad y eficiencia de sedación balanceada con propofol y remifentanil en endoscopia digestiva alta diagnóstica. Una experiencia exitosa

Intraoperative Remifentanilgabe und postoperative Schmerztherapie

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