Use of Remifentanil in Patients Breathing Spontaneously during Monitored Anesthesia Care and in the Management of Acute Postoperative Care

Remifentanil na prática clínica

“…Para complementar anestesia local para biópsia de mama, a associação de midazolam (2 mg) por via venosa permitiu reduzir a infusão média de remifentanil de 0,11 para 0,07 µg.kg -1 .min -1 , com menor incidência de ansiedade, sedação mais intensa e menor incidência de lembrança da injeção 58 . Acredita-se que o uso para sedação só deve ser iniciado após o anestesiologista adquirir experiência suficiente com esse fármaco durante anestesia geral em pacientes intubados, sem nunca esquecer que a oximetria de pulso fornecerá apenas sinais tardios de depressão respiratória no paciente que estiver recebendo oxigênio suplementar 59 .…”

“…To complement local anesthesia for breast biopsy, the association of intravenous midazolam (2 mg) has decreased mean remifentanil infusion from 0.11 to 0.07 µg.kg -1 .min -1 , with lower incidence of anxiety, deeper sedation and lower incidence of injection memory 58 . It is believed that sedation with remifentanil should only be induced after anesthesiologists' have enough experience with this drug in general anesthesia in intubated patients, never forgetting that pulse oximetry will only provide late respiratory depression signals in patients receiving oxygen 59 .…”

Remifentanilversus propofol for radio frequency treatment of atrial flutter

“…Despite a significant rise in PaCO 2 at the end of the procedure, pulse oximetry detected only 5% of events. This shows a limitation of oxygen saturation monitoring as a sole measure of ventilatory adequacy in spontaneously breathing patients, as demonstrated by Ramsay et al 18 and capnography using an auricular sensor or a device attached to the face mask could be valuable. 19 Contrary to the patients with respiratory depression in Group P, three patients in Group R with respiratory depression could be verbally stimulated by the anesthesiologist when oxygen saturation was decreasing.…”

Assessment of Preoperative Anxiety and Influencing Factors in Patients Undergoing Elective Surgery: An Observational Cross-Sectional Study

“…Preoperative anxiety is a common and natural psychological response [ 1 ], with a prevalence ranging from 11 to 80%, according to the literature [ 2 , 3 , 4 ]. Interestingly, this anxiety is predominantly attributed to the prospect of anesthesia (65%) rather than the surgery itself (15%) [ 5 ]. Preoperative anxiety can be caused by several factors, including fear of postoperative pain, awakening during surgery, not waking up after surgery, postoperative nausea and vomiting (PONV), and loss of inhibition while under anesthesia [ 1 , 2 , 6 , 7 ].…”