title: Safety and efficacy of remifentanil in craniosynostosis repair in children less than 1 year old.
abstract: Few studies on analgesia with remifentanil (Rf) in children are available, and there are no data on the use of this drug in pediatric neurosurgery. Rf is a new mu-receptor opioid agonist, acting through the activation of pain inhibitory mechanisms. We conducted a prospective trial on the analgesic effects of Rf in 20 children less than 1 year of age undergoing a neurosurgical procedure for craniosynostosis repair. Rf was administered at doses of 0.25 microgram/kg/min, by continuous infusion, 1 h after admission to the pediatric intensive care unit (PICU). The treatment was prolonged for 12 h after the operation. The postoperative pain was evaluated in our PICU, comparing the changing of behavioral (AFS and CHEOPS score) and hemodynamic (heart rate, respiratory rate, systolic and diastolic blood pressure, oxygen saturation, O(2) and CO(2) partial pressure) parameters, before and after treatment with Rf. This drug showed a satisfactory pain control in all the children treated. No significant side effects were noticed, except for one episode of urinary retention. In conclusion, Rf appears to be safe and effective for the treatment of acute pain in the very young child submitted to craniosynostosis repair.
authors.affiliation: Pediatric Intensive Care Unit, Catholic University Medical School, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Chiaretti
authors.forename: D
authors.initials: D
authors.lastname: Pietrini
authors.forename: M
authors.initials: M
authors.lastname: Piastra
authors.forename: G
authors.initials: G
authors.lastname: Polidori
authors.forename: A
authors.initials: A
authors.lastname: Savioli
authors.forename: F
authors.initials: F
authors.lastname: Velardi
authors.forename: F
authors.initials: F
authors.lastname: Ciano
authors.forename: C
authors.initials: C
authors.lastname: Di Rocco
mesh_terms: D000367:Age Factors; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D001921:Brain / Q000098:blood supply; D002560:Cerebrovascular Circulation; D003398:Craniosynostoses / Q000601:surgery*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D000077208:Remifentanil; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil