Targeting the opioid remifentanil: Protective effects and molecular mechanisms against organ ischemia-reperfusion injury

Yi, Shuyuan; Cao, Hong; Zheng, Weilei; Wang, Yin; Li, Peifeng; Wang, Shoushi; Zhou, Zhixia

doi:10.1016/j.biopha.2023.115472

Cited by 6 publications

(3 citation statements)

References 111 publications

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“…Rashad et al confirmed that dexmedetomidine not only maintains preferred hemodynamics but also reduces the need for postoperative analgesics and decreases the occurrence of nausea and vomiting [ 42 ]. Remifentanil exerts protective effects on ischemic reperfusion organ injuries by reducing intracellular calcium, activating anti-apoptotic pathways, and regulating reactive oxygen species, as viewed from another perspective [ 43 – 45 ]. The analysis indicated lower hazard ratios (HRs) only within the initial 15 min following remifentanil induction (SMD: -0.24 [-0.83, 0.34]; I2: 81.22%).…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis

Janipour,

Bastaninejad,

mohebbi

et al. 2024

BMC Anesthesiol

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Background Nasal surgeries, addressing anatomical variations for form and function, require careful anesthesia administration, including dexmedetomidine and remifentanil. This meta-analysis evaluates their safety and efficacy variations in nasal surgeries, emphasizing patient comfort and optimal outcomes. Methods Four electronic databases (PubMed, Scopus, Web of Science, and CINAHL Complete) were searched for records in English. Studies that measure the effect of dexmedetomidine versus remifentanil on patients underwent nasal surgery were included. The Cochrane Collaboration’s tool was used to assess the quality of the included studies. A random-effect model was preferred and statistical analysis was performed by Stata software version 17. Results Out of an initial pool of 63 articles, five studies were selected for this analysis. All of these chosen studies were Randomized Controlled Trials (RCTs). The meta-analysis involved a total of 302 participants, with 152 in the remifentanil group and 150 in the dexmedetomidine group. The analysis aimed to compare the effects of Dexmedetomidine and Remifentanil on heart rate (HR) and mean arterial pressure (MAP) during surgery. Both groups exhibited similar MAP and HR, with the exception of a slightly lower HR in the remifentanil group at the 15th minute of surgery (Standardized Mean Difference: -0.24 [-0.83, 0.34]). Furthermore, when evaluating the impact of these medications on post-surgery outcomes, including pain levels, the use of pain relief medications, patient-surgeon satisfaction, agitation scores, and recovery time, no significant differences were observed between the two medications in any of these aspects. Conclusion In summary, the study compared Dexmedetomidine and Remifentanil in nasal surgeries anesthesia. No significant differences were found in heart rate, blood pressure, satisfaction, pain, agitation, or recovery time. The study had limitations, and future research should establish standardized protocols and consider various surgical factors.

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis

Janipour,

Bastaninejad,

mohebbi

et al. 2024

BMC Anesthesiol

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“…At present, sufentanyl TCI has not yet widely used, because that there is no clinical pain degree monitoring gold standard and mature closed-loop target control infusion equipment, we expect to study the best index of pain degree monitoring, according to the patients with pain degree, automatically adjust the speed of analgesic infusion, and maintain the analgesia level within the scope of the target set. TCI may also be applied to systemic treatment of chronic cancer pain and severe patients [22]. Without inhibiting the patient's respiratory and circulatory system.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effect of Target-Controlled Infusion of Sufentanil and Remifentanil for Internal Thoracoscopy

Duan,

Wang,

Wang

et al. 2023

cmf

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Objective: To analyze the anesthetic effect of internal thoracoscopic surgery with sufentanil and remifentanil target-controlled infusion intravenous anesthesia. Methods: Eighty patients who underwent internal thoracoscopic examination at the endoscopy center of our hospital were selected for analysis. The selected 80 patients were grouped by random number table. 40 patients received sufentanil target-controlled infusion vein. Anesthesia was used as the study group. The remaining 40 patients received remifentanil target-controlled infusion intravenous anesthesia as a control group, and the anesthetic effects of the two groups of patients after receiving different anesthetic target-controlled infusion measures were compared. Results: After the two groups of patients received different anesthetic drug target-controlled infusion measures, the circulation was stable during the operation. The difference of pain visual analog scores was not obvious 30 minutes after the end of the operation. There was a significant difference in the wake-up time between the two groups. There was no significant difference in the incidence of adverse reactions between the two groups after surgery. Conclusions: In patients with clinical thoracoscopic surgery, remifentanil and remifentanil can be used for target-controlled infusion intravenous anesthesia, but patients in the remifentanil group can wake up more quickly and can be promoted and applied.

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“…It also takes part in general anesthesia induction and maintenance as a component of total intravenous anesthesia ( Grape et al, 2019 ; Sridharan and Sivaramakrishnan, 2019 ; Ren et al, 2022 ). Remifentanil can attenuate the IRI of organs through multiple mechanisms, such as anti-inflammatory, antioxidant, and anti-apoptotic signaling pathways, that have attracted the attention of scholars ( Yi et al, 2023 ). Some scholars have confirmed the protective effects of remifentanil on intestinal IRI in their studies.…”

Section: Remifentanilmentioning

confidence: 99%

Attenuation of intestinal ischemia-reperfusion-injury by anesthetics: a potentially protective effect of anesthetic management in experimental studies

Huang,

Bai,

Chen

et al. 2024

Front. Pharmacol.

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Intestinal ischemia-reperfusion injury (IRI) is a potentially severe clinical syndrome after major surgical procedures. In addition to causing intestinal mucosa injury, intestinal IRI further damages distant organs, causing the severity of the condition in patients. So far, effective therapy for intestinal IRI is still absent, and the survival rate of the patients is low. Previous experimental studies have shown that some anesthetics can alleviate intestinal IRI and protect organs while exerting their pharmacological effects, indicating that reasonable perioperative anesthesia management may provide potential benefits for patients to avoid intestinal IRI. These meaningful findings drive scholars to investigate the mechanism of anesthetics in treating intestinal IRI in-depth to discuss the possible new clinical uses. In the present mini-review, we will introduce the protective effects of different anesthetics in intestinal IRI to help us enrich our knowledge in this area.

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Targeting the opioid remifentanil: Protective effects and molecular mechanisms against organ ischemia-reperfusion injury

Cited by 6 publications

References 111 publications

Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis

Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis

Clinical Effect of Target-Controlled Infusion of Sufentanil and Remifentanil for Internal Thoracoscopy

Attenuation of intestinal ischemia-reperfusion-injury by anesthetics: a potentially protective effect of anesthetic management in experimental studies

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