JOURNAL BROWSE
Search
Advanced SearchSearch Tips
Effect-site Concentration of Alfentanil or Remifentanil for the Relief of Postoperative Pain in the Intensive Care Unit Patients
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
  • Journal title : International Journal of Contents
  • Volume 11, Issue 2,  2015, pp.69-73
  • Publisher : The Korea Contents Association
  • DOI : 10.5392/IJoC.2015.11.2.069
 Title & Authors
Effect-site Concentration of Alfentanil or Remifentanil for the Relief of Postoperative Pain in the Intensive Care Unit Patients
Jang, Hae-Lan; Kang, Hoon;
  PDF(new window)
 Abstract
This study was performed to determine the optimal doses of alfentanil or remifentanil (effect-site concentrations) required to prevent pain and other suffering after abdominal general surgery in ICU patients. A total of 52 general abdominal surgical patients (ASA IIIII) requiring artificial ventilatory care in the ICU were provided with either alfentanil (24 patients) or remifentanil (28 patients) through target controlled infusion (TCI). Alfentanil and remifentanil concentrations were titrated up and down until the pain score became less than 3 (VAS; Visual Analogue Score < 3). The effect-site concentrations (ng/ml) of alfentanil or remifentanil required to adequately control postoperative pain in the ICU were 64 +/- 12 and 1.9 +/- 0.5 for intubation with artificial ventilation, 57 +/- 9 and 1.7 +/- 0.7 for intubation with spontaneous ventilation, and 41 +/- 10 and 1.2 +/- 0.5 after extubation, respectively. Pain scores and the corresponding opioid concentrations were independent from respiratory condition. The three effect-site concentrations of alfentanil and remifentanil obtained from this clinical trial using the TCI technique can be a guideline in the administration of the same opioids to relieve the discomfort of ICU patients who have undergone abdominal general surgery.
 Keywords
Alfentanil;Remifentanil;Effect-site Concentrations;Target Controlled Infusion;
 Language
English
 Cited by
 References
1.
C. L. Westmoreland, J. F. Hoke, P. S. Sebel, C. C. Hug Jr., and K. T. Muir, “Pharmacokinetics of remifentanil (GI87084B) and its major metabolite (GR90291) in patients undergoing elective surgery,” Anesthesiology, vol. 79, no. 5, 1993, pp. 893-903. crossref(new window)

2.
A. Kapila, P. S. Glass, Jacobs Jr., K. T. Muir, D. J. Hermann, M. Shiraishi, S. Howell, and R. L. Smith, “Measured context-sensitive half-times of remifentanil and alfentanil,” Anesthesiology, vol. 83, no. 5, 1995, pp. 968-975. crossref(new window)

3.
J. Vuyk, T. Lim, F. H. Engbers, A. G. Burm, A. A. Vletter, and J. G. Bovill, “Pharmacodynamics of alfentanil as a supplement to propofol of nitrous oxide for lower abdominal surgery in female patients,” Anaesthesiology, vol. 78, 1993, pp.1036-1045. crossref(new window)

4.
J. Vuyk, T. Lim, F. H. Engbers, A. G. Burm, A. A. Vletter, and J. G. Bovill, “The pharmacodynamic interaction of propofol and alfentanil during lower abdominal surgery in women,” Anaesthesiology, vol 83, 1995, pp. 8-22. crossref(new window)

5.
D. P. Crankshaw, D. J. Morgan, G. H. Beemer, and F. Karrasawa, “Pre-programmed infusion of alfentanil to constant arterial plasma concentration,” Anesthesia and Analgesia, vol. 76, no. 3, Mar. 1993, pp. 556-561. crossref(new window)

6.
C. L. Westmoreland, P. S. Sebel, and A. Gropper, “Fentanil or alfentanil decreases the minimal alveolar anaesthetic concentration of isoflurane in surgical patients,” Anesthesia and Analgesia, vol. 78, no. 1, Jan. 1994, pp. 23-28. crossref(new window)

7.
F. W. Davies, M. White, and G. N. Kenny, “Postoperative analgesia using a computerised infusion of alfentanil following aeortic bifurcation graphed surgery,” Int J Clin Mon Comp, vol. 9, no. 4, Dec. 1992, pp. 207-212. crossref(new window)

8.
E. Lang, A. Kapila, D. Shlugman, J. F. Hoke, P. S. Sebel, and P. S. Glass, “Reduction of isoflurane minimal alveolar concentration by remifentanil,” Anesthesiology, vol. 85, no. 4, 1996, pp. 721-728. crossref(new window)

9.
R. J. Fragen, G. I. Randel, E. S. Librojo, M. Y. Clarke, and B. D. Jamerson, “The interaction of remifentanil and propofol to prevent response to tracheal intubation and the start of surgery for outpatient knee arthroscopy [abstract],” Anesthesiology, vol. 81, 1994, p.A376. crossref(new window)

10.
A. Kapila, P. S. Glass, Jacobs JR, D. J. Hermann, M. Shiraishi, S. Howell, and R. L. Smith, “Measured contextsensitive half-times of remifentanil and alfentanil,” Anesthesiology, vol. 83, no. 5, 1995, pp. 968-975. crossref(new window)

11.
A. I. McEwan, C. Smith, O. Dyar, D. Goodman, L. R. Smith, and P. S. Glass, “Isoflurane minimal alveolar concentration reduced by Fentanyl,” Anesthesiology, vol. 78, no. 5, 1993, pp. 864-869. crossref(new window)

12.
T. Katoh, T. Uchiyama, and K. Ikeda, “ Effect of fentanyl on awakening concentration of Sevoflurane,” British Journal of Anaesthesia, vol. 73, 1994, pp. 322-325. crossref(new window)

13.
C. Smith, A. I. McEwan, Jhaveri R. et al., “The interaction of fentanyl on the Cp50 of propofol for loss of consciousness and skin incision,” Anesthesiology, vol. 81, 1994, pp. 820-828. crossref(new window)

14.
M. A. Hughes, P. S. Glass, and Jacobs JR, “Contextsensitive half-time in the multicompartment pharmacokinetic models for intravenous anaesthetic drugs,” Anesthesiology, vol. 76, 1992, pp. 334-341. crossref(new window)

15.
Jm. Bailey, “Pharmacodynamics as a research tool,” Journal Clin Anaesth, vol. 8, 1996, pp. 42S-52S. crossref(new window)

16.
L. E. Mather, W. B. Runciaman, A. H. Ilsley, R. J. Carapetis, and R. N. Upto, “A ship preparation for studying interactions between bloods flow and drug disposition. V. The effects of general anesthesia and subarachnoid anaesthesia on blood flow and pethidine disposition,” British J Anaesth, vol. 58, 1986, pp. 888-896. crossref(new window)

17.
A. Tamsen, P. Hartvig, C. Fagerlund, and B. Dahlstrom, “Patient-controlled analgesic therapy. Part II: individual analgesic demand and analgesic concentrations of pethidine in post-operative Pain,” Clin Pharmacokinetics, vol. 7, 1985, pp. 164-175. crossref(new window)