Remifentanil in critically ill cardiac patients.
Ann Card Anaesth
;
2011 Jan; 14(1): 6-12
Article
in English
| IMSEAR
| ID: sea-139555
ABSTRACT
Remifentanil has a unique pharmacokinetic profile, with a rapid onset and offset of action and a plasmatic metabolism. Its use can be recommended even in patients with renal impairment, hepatic dysfunction or poor cardiovascular function. A potential protective cardiac preconditioning effect has been suggested. Drug-related adverse effects seem to be comparable with other opioids. In cardiac surgery, many randomized controlled trials demonstrated that the potential benefits of the use of remifentanil not only include a profound protection against intraoperative stressful stimuli, but also rapid postoperative recovery, early weaning from mechanical ventilation, and extubation. Remifentanil shows ideal properties of sedative agents being often employed for minimally invasive cardiologic techniques, such as transcatheter aortic valve implantation and radio frequency treatment of atrial flutter, or diagnostic procedures such as transesophageal echocardiography. In intensive care units remifentanil is associated with a reduction in the time to tracheal extubation after cessation of the continuous infusion; other advantages could be more evident in patients with organ dysfunction. Effective and safe analgesia can be provided in case of short and painful procedures (i.e. chest drain removal). In conclusion, thanks to its peculiar properties, remifentanil will probably play a major role in critically ill cardiac patients.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Piperidines
/
Humans
/
Critical Illness
/
Anesthetics, Intravenous
/
Cardiac Surgical Procedures
/
Analgesics, Opioid
/
Hypnotics and Sedatives
/
Intensive Care Units
/
Anesthesia
Type of study:
Controlled clinical trial
Language:
English
Journal:
Ann Card Anaesth
Year:
2011
Type:
Article
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