title: Remifentanil target-controlled infusion: a safe rescue protocol for unexpected severe postoperative pain.
abstract: Three cases are reported here in which remifentanil administered as a target-controlled infusion (TCI) was used in Post Anesthesia Care Unit as a fast rescue treatment for acute and unexpected severe postoperative pain, allowing subsequent clinical evaluation and rational titration of analgesia with longer acting opioids. It illustrates the efficacy of this technique to titrate and compensate for variability in opioid requirements. However, its safety requires full knowledge of TCI technique, continuous monitoring of respiratory function, and assisted ventilation equipment immediately available.
authors.affiliation: Anesthesia Department, Institut Gustave Roussy, Villejuif, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Motamed
authors.affiliation: Anesthesia Department, Institut Gustave Roussy, Villejuif, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Weil
authors.affiliation: Interventional Radiology Department, Institut Gustave Roussy, Villejuif, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Deschamps
authors.affiliation: Anesthesia Department, Institut Gustave Roussy, Villejuif, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Billard
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000762:Anesthesia Recovery Period; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000077208:Remifentanil; D056152:Respiratory Rate / Q000187:drug effects; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil