Document Detail


Remifentanil in critically ill cardiac patients.
MedLine Citation:
PMID:  21196668     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Laura Ruggeri; Giovanni Landoni; Fabio Guarracino; Sabino Scolletta; Elena Bignami; Alberto Zangrillo
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of cardiac anaesthesia     Volume:  14     ISSN:  0974-5181     ISO Abbreviation:  Ann Card Anaesth     Publication Date:    2011 Jan-Apr
Date Detail:
Created Date:  2011-01-03     Completed Date:  2011-05-18     Revised Date:  2011-10-03    
Medline Journal Info:
Nlm Unique ID:  9815987     Medline TA:  Ann Card Anaesth     Country:  India    
Other Details:
Languages:  eng     Pagination:  6-12     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Intensive Care Medicine, Università Vita-Salute San Raffaele, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / pharmacology
Anesthesia / methods
Anesthetics, Intravenous / pharmacology
Cardiac Surgical Procedures*
Critical Illness*
Humans
Hypnotics and Sedatives / pharmacology
Intensive Care Units
Piperidines / adverse effects,  pharmacokinetics,  pharmacology*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anesthetics, Intravenous; 0/Hypnotics and Sedatives; 0/Piperidines; 132875-61-7/remifentanil
Comments/Corrections
Comment In:
Ann Card Anaesth. 2011 Sep-Dec;14(3):242-3   [PMID:  21860204 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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