title: Remifentanil for tracheal tube tolerance: a case control study.
abstract: We assessed the minimal remifentanil dosage required for tracheal tube tolerance in awake and spontaneously breathing patients after major abdominal surgery. Forty postoperative patients received remifentanil 0.1 microg.kg(-1).min(-1), which was reduced in steps of 0.025 microg.kg(-1).min(-1) every 30 min. Respiratory response subscore of comfort scale (CSRR), Ramsay sedation scale (RSS), visual analogue scale (VAS), respiratory rate, and minute ventilation were recorded. Spontaneous respiration with no or little response to ventilation (CSRR 2) in co-operative, oriented and tranquil patients (RSS 2) was defined as the main outcome and study endpoint. Thirty-one patients (77.5%) reached a CSRR 2 and RSS 2 with remifentanil 0.025 microg.kg(-1).min(-1) and nine patients (22.5%) required remifentanil 0.05 microg.kg(-1).min(-1). Analgesia was sufficient in all patients (VAS = 30). Remifentanil 0.025-0.05 microg.kg(-1).min(-1) achieves satisfactory tracheal tube tolerance in awake and spontaneously breathing patients.
authors.affiliation: Department of Anaesthesiology and General Intensive Care, Medical University of Vienna, General Hospital, Waehringer Geurtel 18-20, 1090 Vienna, Austria. anette-marie.machata@meduniwien.ac.at
authors.forename: A M
authors.initials: AM
authors.lastname: Machata
authors.forename: U M
authors.initials: UM
authors.lastname: Illievich
authors.forename: B
authors.initials: B
authors.lastname: Gustorff
authors.forename: C
authors.initials: C
authors.lastname: Gonano
authors.forename: K
authors.initials: K
authors.lastname: Fässler
authors.forename: C K
authors.initials: CK
authors.lastname: Spiss
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D016022:Case-Control Studies; D016292:Procedural Sedation / Q000379:methods; D003422:Critical Care / Q000379:methods; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D011182:Postoperative Care / Q000379:methods*; D000077208:Remifentanil; D015656:Respiratory Mechanics / Q000187:drug effects
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil