title: Remifentanil prevents increases of blood glucose and lactate levels during cardiopulmonary bypass in pediatric cardiac surgery.
abstract: BACKGROUND
  Cardiopulmonary bypass (CPB) can cause stress response that increases levels of cytokine and catecholamine in plasma, resulting in hyperglycemia. In adults, it has been demonstrated that remifentanil infusion during CPB could prevent increases of cytokine, catecholamine, and blood glucose levels, but such effects of remifentanil in children have not been elucidated.
  
  
  OBJECTIVE
  In this study, we investigated the preventive effects of remifentanil on blood glucose and lactate levels during CPB in children.
  
  
  METHODS
  This retrospective study included children who underwent ventricular septal defect or atrial septal defect closure. Data for patients who did not receive, during CPB period, remifentanil infusion (non-Remi group) and patients who received remifentanil infusion at 0.5 μg/kg/min (Remi group) during CPB were used for analysis. Primary outcomes were lactate and blood glucose levels just before and after CPB. Data are presented as medians and interquartile ranges. Data were analyzed by the Mann-Whitney U-test and Chi-square test. A P < 0.05 was considered statistically significant.
  
  
  RESULTS
  During CPB, 13 and 11 patients were allocated into Remi and non-Remi groups, respectively. Pre-CPB lactate and blood glucose levels were not significantly different between the two groups, but post-CPB lactate and blood glucose levels in the Remi group were significantly lower than that in the non-Remi group.
  
  
  CONCLUSIONS
  0.5 μg/kg/min remifentanil infusion during CPB suppresses the increases of blood glucose and lactate levels in children.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Chaki
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nawa
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Tamashiro
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Mizuno
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hirata
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Yamakage
mesh_terms: D001786:Blood Glucose / Q000187:drug effects*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000097:blood / Q000494:pharmacology*; D007223:Infant; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D010880:Piperidines / Q000097:blood / Q000494:pharmacology*; D000077208:Remifentanil; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006993:Hypnotics and Sedatives; D010880:Piperidines; D019344:Lactic Acid; D000077208:Remifentanil