title: Severe remifentanil-induced acute opioid tolerance following awake craniotomy in an adolescent.
abstract: Anesthetic goals for procedures involving resections close to the motor cortex include immobility, analgesia, and a level of consciousness that allows for the ability to follow motor commands. Remifentanil as a single agent is an attractive choice, particularly when ventilation is controlled. The successful use of large-dose remifentanil infusion during an awake craniotomy in a 16 year-old man and the subsequent severe acute opioid tolerance is presented.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. strickerp@email.chop.edu
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stricker
authors.forename: F Wickham
authors.initials: FW
authors.lastname: Kraemer
authors.forename: Arjunan
authors.initials: A
authors.lastname: Ganesh