Rémifentanil: dépression respiratoire postopératoire à l'occasion d'une purge de la tubulure de perfusion

Fourel, D.; Almanza, Laura Herrera; Aubouin, J.P.; Guiavarc'H, Mikaël

doi:10.1016/s0750-7658(99)80062-8

Cited by 6 publications

(1 citation statement)

References 2 publications

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“…The three-way stopcock, which is usually used to bring remifentanil into the main infusion line, should be as close as possible to the patient to avoid useless dead space. If a one-way valve is not used, the infusion line should always be carefully purged before recovery and extubation, to avoid delayed boluses leading to apnoea Fourel et al 1999). The risks of muscle rigidity at induction of anaesthesia (Schuttler et al 1997) and/or of haemodynamic instability in risk patients (Elliott et al 2000) preclude the use of important bolus doses unless administered over at least 30 s. Nevertheless, titration and experience will reduce the incidence of unwanted side-effects (Joshi et al 2000).…”

Section: Administration Modesmentioning

confidence: 99%

Remifentanil and Other Opioids

Servin

Billard

Handbook of Experimental Pharmacology

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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.

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