Effect of remifentanil on intracranial pressure and cerebral blood flow velocity in patients with head trauma

Engelhard, Kristin; Reeker, W.; Kochs, Eberhard; Werner, Christian

doi:10.1111/j.0001-5172.2004.00348.x

Cited by 49 publications

(21 citation statements)

References 13 publications

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“…In patients with traumatic brain injury, it has been demonstrated that remifentanil has no significant changes in systematic and cerebral haemodynamics, such as intracranial pressure, mean blood pressure (BP), cerebral perfusion pressure and cerebral blood flow velocity 22. Several studies also compared remifentanil with fentanyl or morphine as an analgesic in neurological ICU patients.…”

Section: Introductionmentioning

confidence: 99%

Short-term use of remifentanil during endotracheal extubation for prophylactic analgesia in neurosurgical patients after craniotomy (SURE after Craniotomy Study): a study protocol and statistical analysis plan for a randomised controlled trial

Chen

Zhou

2014

BMJ Open

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IntroductionAcute pain is common during the endotracheal extubation period, and is related to complications and adverse outcomes. Patients with delayed extubation after craniotomy are vulnerable to pain and complications of extubation. However, pain control during extubation is still inadequate. Remifentanil, a new opioid with rapid onset and short duration of action, provides adequate analgesia during procedures with minimal effect of respiratory depression.Methods and analysisThe study is a prospective, randomised, double-blinded, controlled parallel-group design. Patients with delayed extubation after intracranial surgery are screened daily. Adult patients ready for extubation are enrolled and assigned randomly to one of the two treatment study groups, labelled as the ‘Remi group’ or ‘Saline group’. Patients in the Remi group receive an intravenous bolus dose of remifentanil 0.5 μg/kg over 60 s followed by a continuous infusion 0.05 μg/kg/min for 20 min. Patients in the Saline group receive an intravenous infusion of 0.9% sodium chloride at a volume and rate equal to that of remifentanil. Pain intensity is measured by the visual analogue scale (VAS) pain score. Adverse events during drug infusion are documented and reported. Patients will be followed up until hospital discharge, death or 60 days after the trial intervention on a first come, first served basis. Details of the incidence of reintubation and reoperation within 72 h after extubation, length of stay in the intensive care unit and hospital and mortality are collected. The primary end point is the incidence of severe pain (defined as a VAS pain score more than 5 cm) during the periextubation period (defined as the period of time from immediately before extubation to 20 min after extubation).Ethics and disseminationThe study was approved by the Institutional Review Board (IRB) of the Beijing Tiantan Hospital, Capital Medical University. The study findings will be disseminated through peer-reviewed publications and conference presentations.Trial registration numberClinicalTrials (NCT): ChiCTR-PRC-13003879.

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Section: Introductionmentioning

confidence: 99%

Short-term use of remifentanil during endotracheal extubation for prophylactic analgesia in neurosurgical patients after craniotomy (SURE after Craniotomy Study): a study protocol and statistical analysis plan for a randomised controlled trial

Chen

Zhou

2014

BMJ Open

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“…Remifentanil (bolus of 0.5 μg/kg, followed by a continuous infusion 0.25 μg/kg/min for 20 min) can also be used for on‐top analgesia in head trauma patients without adverse effects on cerebrovascular hemodynamics and CPP (43).…”

Section: Cerebral Perfusion Pressure (Cpp)mentioning

confidence: 99%

Remifentanil and the brain

Fodale

Schifilliti

Praticò

et al. 2008

Acta Anaesthesiol Scand

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“…Different studies, carried out to investigate the effects of opioids, both alone and in combination with other anesthetic agents, demonstrated how these drugs could affect cerebral hemodynamics with consequent increases in ICP and reduction in CBF (69).…”

Section: Anesthetic Agentsmentioning

confidence: 99%

Transcranial Doppler and anesthetics

Fodale

Schifilliti

Conti

et al. 2007

Acta Anaesthesiol Scand

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Transcranial Doppler (TCD) is widely used to investigate the effects of anesthetic drugs on cerebral blood flow. Its repeatability and non-invasivity makes it an ideal, first choice method. Anesthesia providers are required to be conscious of the cerebral hemodynamic effects of drugs given in their practice, especially in neurosurgery and in subjects with impaired brain functions. The purpose of this review is to present the basic concepts of the TCD technique and the effects on cerebral hemodynamics of the most popular anesthetic drugs evaluated using TCD ultrasonography.

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Effect of remifentanil on intracranial pressure and cerebral blood flow velocity in patients with head trauma

Abstract: These data suggest that remifentanil can be used for on-top analgesia in head trauma patients without adverse effects on cerebrovascular haemodynamics, cerebral perfusion pressure or intracranial pressure.

Cited by 49 publications

References 13 publications

Short-term use of remifentanil during endotracheal extubation for prophylactic analgesia in neurosurgical patients after craniotomy (SURE after Craniotomy Study): a study protocol and statistical analysis plan for a randomised controlled trial

Short-term use of remifentanil during endotracheal extubation for prophylactic analgesia in neurosurgical patients after craniotomy (SURE after Craniotomy Study): a study protocol and statistical analysis plan for a randomised controlled trial

Remifentanil and the brain

Transcranial Doppler and anesthetics

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