Probable seizure after remifentanil in a 4‐year‐old boy

Blair, J. M.; Hill, David A.

doi:10.1046/j.1365-2044.2000.01425-19.x

Cited by 16 publications

(6 citation statements)

References 4 publications

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“…There were two protocol violations during this study, one each in groups Rem2 and Rem3. Another child, in the Rem2 group, had a tonic-clonic seizure during induction [10]. No data were included in the analysis for these three subjects.…”

Section: Resultsmentioning

confidence: 99%

Assessment of tracheal intubation in children after induction with propofol and different doses of remifentanil

et al. 2004

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Tracheal intubating conditions were assessed in 112 children after induction of anaesthesia with propofol and remifentanil 1.0, 2.0 or 3.0 micro g.kg-1. Subjects in a control group were given propofol and mivacurium 0.2 mg.kg-1. Haemodynamic and respiratory parameters were recorded. Plasma catecholamine levels were measured in a subgroup of 40 children. Intubating conditions were acceptable in 14/28 (50%), 18/26 (69%) and 22/27 (82%) in those subjects given remifentanil 1.0, 2.0 or 3.0 micro g.kg-1, respectively, and in 27/28 (96%) of the control group. Intubating conditions in subjects given remifentanil 3.0 micro g.kg-1 were better than in those given remifentanil 1.0 micro g.kg-1 (p < 0.05). There were no significant differences in intubating conditions between those given remifentanil 3.0 micro g.kg-1 and the control group. Systolic blood pressure and heart rate increased in response to tracheal intubation in subjects given remifentanil 1.0 micro g.kg-1 and in the control group (p < 0.05). Time to resumption of spontaneous respiration was prolonged in subjects given remifentanil 3.0 micro g.kg-1 (p < 0.001). In conclusion, remifentanil 2 micro g.kg-1 provides acceptable intubating conditions and haemodynamic stability without prolonging the return of spontaneous respiration.

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Section: Resultsmentioning

confidence: 99%

Assessment of tracheal intubation in children after induction with propofol and different doses of remifentanil

et al. 2004

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“…Although CNS effects are more common with meperidine, they have also been reported with other opioids including morphine, fentanyl, alfentanil, and remifentanil. [11–14] As with chest wall rigidity, the CNS effects are thought to be related to excitation of pyramidal neurons of the hippocampus due to inhibition of interneurons of the GABA system.…”

Section: Adverse Effects Of Sedative and Analgesic Agentsmentioning

confidence: 99%

Procedural sedation: A review of sedative agents, monitoring, and management of complications

2011

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Given the continued increase in the complexity of invasive and noninvasive procedures, healthcare practitioners are faced with a larger number of patients requiring procedural sedation. Effective sedation and analgesia during procedures not only provides relief of suffering, but also frequently facilitates the successful and timely completion of the procedure. However, any of the agents used for sedation and/or analgesia may result in adverse effects. These adverse effects most often affect upper airway patency, ventilatory function or the cardiovascular system. This manuscript reviews the pharmacology of the most commonly used agents for sedation and outlines their primary effects on respiratory and cardiovascular function. Suggested guidelines for the avoidance of adverse effects through appropriate pre-sedation evaluation, early identification of changes in respiratory and cardiovascular function, and their treatment are outlined.

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“…To our knowledge two previous cases of seizures after administration of remifentanil have been reported in the literature (1,2), a search in the WHO database showed few additional cases. We have experienced seizures in a patient with no previous history of epilepsy after a 50-mg bolus dose of remifentanil.…”

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confidence: 80%