title: Effects of remifentanil on the cardiac conduction system. Our experience in the study of remifentanil electrophysiological properties.
abstract: Remifentanil is a selective mu-opioid receptor agonist characterized by a rapid onset and ultrashort predictable duration of action providing intense analgesia without prolonged respiratory depression. Remifentanil has been implicated in the causation of intraoperative bradyarrhythmias and asystole both in adults and in pediatric patients. Electrophysiological studies in humans and animals show that remifentanil provokes a dose-dependent depressor effect on sinus and AV node function, manifested by a significant prolongation of sinus node recovery time, sino-atrial conduction time and Wenckebach cycle length. These electrophysiologic effects of remifentanil suggest that it should be used with attention in vulnerable patients with predisposition to bradiarritmias during anesthesia.
authors.forename: Brezo B
authors.initials: BB
authors.lastname: Del Blanco Narciso
authors.forename: Concepción
authors.initials: C
authors.lastname: Jimeno Fernandez
authors.forename: Jesús
authors.initials: J
authors.lastname: Almendral Garrote
authors.forename: M Jose
authors.initials: MJ
authors.lastname: Anadon Baselga
authors.affiliation: Department of Anaesthesiology, Hospital Clínico Universitario San Carlos, C/ Porfesor Martin Lagos s/n. C.P: 28040. Madrid. Spain. brezodelblanco@yahoo.es.
authors.forename: Matilde
authors.initials: M
authors.lastname: Zaballos Garcia
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000818:Animals; D001283:Atrioventricular Node / Q000187:drug effects / Q000502:physiology; D001919:Bradycardia / Q000139:chemically induced / Q000503:physiopathology; D055724:Electrophysiological Phenomena / Q000187:drug effects / Q000502:physiology; D006329:Heart Conduction System / Q000187:drug effects* / Q000502:physiology; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D017450:Receptors, Opioid, mu / Q000819:agonists* / Q000502:physiology; D000077208:Remifentanil; D012849:Sinoatrial Node / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D017450:Receptors, Opioid, mu; D000077208:Remifentanil