A comparison of two constant-dose continuous infusions of remifentanil for severe postoperative pain.
We evaluated the analgesic efficacy and safety of two continuous constant-dose infusions of IV remifentanil, without infusion rate increments or the addition of boluses, in patients with severe postoperative pain during the first 4 h after general anesthesia with IV propofol-remifentanil. Thirty patients were randomly assigned to two groups of 15 subjects each according to the remifentanil dose administered: 0.1 microg. kg(-1). min(-1) IV (Group A) or 0.05 microg. kg(-1). min(-1) IV (Group B). Rescue analgesia was provided with meperidine (0.5 mg/kg IV) when pain intensity on the simple verbal scale (SVS) > or =2. The criteria for adequate analgesia (SVS 0-1, respiratory frequency >8/min. and SpO(2) >90%) after 4 h were met by 78% and 75% of the patients in Groups A and B, respectively (P = ns). "Meperidine rescue" analgesia was significantly more in Group B (26%) than in Group A (6%) (P < 0.05). There were no cases of respiratory depression, and nausea and emesis occurred in one patient in each group (6.5%). We conclude that IV remifentanil is an effective and safe opioid for the treatment of postoperative pain at a constant dose of 0.1 microg. kg(-1). min(-1) with a need for rescue analgesia 4 times less than a constant dose of 0.05 microg. kg(-1). min(-1).


CONCLUSIONS
Our study suggests that the use of a constant continuous infusion of remifentanil 0.1 microg.kg(-1).min(-1)IV is an effective alternative in the treatment of severe postoperative pain.
Anesthesiology Department, Puerta del Mar University Hospital, Cádiz, Spain.
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Calderón
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Pernia
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De Antonio
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Calderón-Pla
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Torres
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D000077208:Remifentanil
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil