No clinical evidence of acute opioid tolerance after remifentanil-based anaesthesia

被引：120

作者：

Cortínez, LI ^{[1
]}

Brandes, V ^{[1
]}

Muñoz, HR ^{[1
]}

Guerrero, ME ^{[1
]}

Mur, M ^{[1
]}

机构：

[1] Catholic Univ Chile, Hosp Clin, Dept Anesthesiol, Santiago, Chile

来源：

BRITISH JOURNAL OF ANAESTHESIA | 2001年 / 87卷 / 06期

关键词：

analgesics opioid; remifentanil; tolerance; pain; postoperative;

D O I：

10.1093/bja/87.6.866

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

We have prospectively assessed whether remifentanil-based anaesthesia is associated with clinically relevant acute opioid tolerance, expressed as greater postoperative pain scores or morphine consumption. Sixty patients undergoing elective gynaecological, non-laparoscopic, surgery were randomly assigned to receive remifentanil (group R, n=30) or sevoflurane (group S, n=30) based anaesthesia. Postoperative analgesia was provided with morphine through a patient-controlled infusion device. Mean (SD) remifentanil infusion rate in group R was 0.23 (0.10) mug kg(-1) min(-1) and mean inspired fraction of sevoflurane in group S was 1.75 (0.70)%. Mean (SD) cumulative morphine consumption during the first 24 postoperative hours was similar between groups: 28.0 (14.2) mg (group R) vs 28.6 (12.4) mg (group S). Pain scores, were also similar between groups during this period. These data do not support the development of acute opioid tolerance after remifentanil-based anaesthesia in this type of surgery.

引用

页码：866 / 869

页数：4

共 19 条

[1]

Albrecht S, 1999, ANESTH ANALG, V89, pS40, DOI 10.1097/00000539-199910001-00008

[2] ACUTE TOLERANCE TO FENTANYL DURING ANESTHESIA IN DOGS [J].

ASKITOPOULOU, H ;

WHITWAM, JG ;

ALKHUDHAIRI, D ;

CHAKRABARTI, M ;

BOWER, S ;

HULL, CJ .

ANESTHESIOLOGY, 1985, 63 (03) :255-261

[3] Long-lasting hyperalgesia induced by fentanyl in rats -: Preventive effect of ketamine [J].

Célèrier, E ;

Rivat, C ;

Jun, Y ;

Laulin, JP ;

Larcher, A ;

Reynier, P ;

Simonnet, G .

ANESTHESIOLOGY, 2000, 92 (02) :465-472

[4] Intraoperative high dose fentanyl induces postoperative fentanyl tolerance [J].

Chia, YT ;

Liu, K ;

Wang, JJ ;

Kuo, MC ;

Ho, ST .

CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1999, 46 (09) :872-877

[5] Preemptive hyperalgesia, not analgesia? [J].

Eisenach, JC .

ANESTHESIOLOGY, 2000, 92 (02) :308-309

[6]

Fairbanks CA, 1997, J PHARMACOL EXP THER, V282, P1408

[7] The efficacy of intravenous 0.15 versus 0.25 mg/kg intraoperative morphine for immediate postoperative analgesia after remifentanil-based anesthesia for major surgery [J].

Fletcher, D ;

Pinaud, M ;

Scherpereel, P ;

Clyti, N ;

Chauvin, M .

ANESTHESIA AND ANALGESIA, 2000, 90 (03) :666-671

[8]

GARDMARK M, 1993, J PHARMACOL EXP THER, V267, P1061

[9] Acute opioid tolerance - Intraoperative remifentanil increases postoperative pain and morphine requirement [J].

Guignard, B ;

Bossard, AE ;

Coste, C ;

Sessler, DI ;

Lebrault, C ;

Alfonsi, P ;

Fletcher, D ;

Chauvin, M .

ANESTHESIOLOGY, 2000, 93 (02) :409-417

[10]

Gustorff B., 2001, European Journal of Anaesthesiology, V18, P138

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