Remifentanil for conscious sedation and analgesia during awake fiberoptic tracheal intubation: a case report with pharmacokinetic simulations.
We report a case of awake, fiberoptic tracheal intubation of a difficult airway (Ludwig's angina) using remifentanil as part of the sedation-analgesia regimen. Remifentanil's rapid onset-rapid offset pharmacokinetic profile enabled precise control of the level of opioid effect. In combination with other drugs, remifentanil may offer some clinical advantages compared to the other fentanyl congeners in providing the opioid component of conscious sedation-analgesia for awake tracheal intubation in patients with difficult airways.
Reusche
M D
MD
Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City 84132, USA.
Egan
T D
TD
D000328:Adult; D000701:Analgesics, Opioid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003198:Computer Simulation; D005336:Fiber Optic Technology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007442:Intubation, Intratracheal; D008297:Male; D010880:Piperidines / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000077208:Remifentanil; D014057:Tomography, X-Ray Computed
D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil