title: Minimizing stress with remifentanil in a patient with Takotsubo undergoing ophthalmic surgery.
abstract: Anesthesiological management of patients with Takotsubo syndrome (TTS) is a challenge of questions related to physiopathology, prognosis, and trigger causes. Relative rarity of this disease and lack of wide literature do not allow to state any negative or positive effect of the variety of drugs available for anesthesia. The authors report a case of a woman with a clear diagnosis of TTS and anxiety disorder, who underwent to cataract extractions at both eyes at two different times. Clinical management is described, from preoperative assessment until discharge of the patient. In both cases, surgery was successfully performed using remifentanil Target Controlled Infusion sedation in spontaneous ventilation. In this article, the authors suggest the possible cardioprotective role of remifentanil in this kind of pathology, focusing on its advantageous sedating action that guarantees a stress-free condition, while maintaining control on respiratory drive.
authors.affiliation: Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Sbaraglia
authors.initials: S
authors.lastname: Fabio
authors.affiliation: Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Garra
authors.initials: G
authors.lastname: Rossella
authors.affiliation: Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: De Riso
authors.initials: de R
authors.lastname: Mariella
authors.affiliation: Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Continolo
authors.initials: C
authors.lastname: Nicola
authors.affiliation: Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Sammartino
authors.initials: S
authors.lastname: Maria
mesh_terms: D000368:Aged; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D005260:Female; D006801:Humans; D013508:Ophthalmologic Surgical Procedures; D010880:Piperidines / Q000494:pharmacology*; D000077208:Remifentanil; D013315:Stress, Psychological / Q000517:prevention & control*; D054549:Takotsubo Cardiomyopathy / Q000503:physiopathology*
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil