A multicenter evaluation of remifentanil for early postoperative analgesia

T. Andrew Bowdle, Enrico M. Camporesi, Laurie Maysick, Charles W. Hogue, Rafael V. Miguel, Melvin Pitts, James B. Streisand

Research output: Contribution to journalArticlepeer-review

Abstract

We evaluated the use of an infusion of remifentanil to provide postoperative analgesia during recovery from total intravenous anesthesia (TIVA) with remifentanil and propofol. One hundred fifty-seven patients from seven medical centers underwent abdominal, spine, joint replacement, or thoracic surgery. Remifentanil was titrated in an effort to limit pain to 0 or 1 on a 0-3 scale. At the end of the 30-min titration period, 78% of infusion rates were in the range of 0.05 to ≤0.15 μg · kg-1 · min-1, 5% were <0.05 μg · kg-1 · min-1, and 17% were >0.15 μg · kg-1 · min-1. Pain scores were 0 or 1 in 64% of patients. Nausea occurred in 35% and emesis in 8% of patients; the peak incidence of nausea followed discontinuation of the remifentanil infusion at the time of administering morphine. Respiratory adverse events (oxygen saturation by pulse oximetry [SpO2] <90% or respiratory rate <12) affected 29% of patients. Apnea occurred in 11 patients (7.0%). There was a large variation in the incidence of respiratory depression between the centers, ranging from 0 to 75%. The explanation for the large variability in respiratory outcome was not evident.

Original languageEnglish (US)
Pages (from-to)1292-1297
Number of pages6
JournalAnesthesia and analgesia
Volume83
Issue number6
DOIs
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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