Remifentanil-assisted local anaesthesia: application to continence surgery.
Remifentanil, an ultrarapid-acting opioid, as an intravenous infusion, generally in combination with a sedative/amnesic (for example midazolam) and local anaesthesia can provide an effective assisted local anaesthetic technique (Remi-ALA) for tension-free vaginal tapes or equivalent continence procedures in urogynaecology. Excellent analgesia for the local anaesthetic injections and tape insertion is provided as well as optimal patient cooperation for clinicians who wish to perform cough testing after tape insertion. Dose-related respiratory depression and, less commonly, bradycardia are possible side-effects, potentially more likely in older women (particularly over 70 years).
Haylen
Bernard T
BT
St Vincent's Clinic, Darlinghurst, New South Wales, Australia. haylen@optusnet.com.au
Katz
Steven
S
Chetty
Naven
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D000077208:Remifentanil; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil