Behavioral and physiological effects of remifentanil and alfentanil in healthy volunteers

被引:42
作者
Black, ML [1 ]
Hill, JL [1 ]
Zacny, JP [1 ]
机构
[1] Univ Chicago, Dept Anesthesia & Crit Care MC4028, Chicago, IL 60637 USA
关键词
behavior; human; opiate; opioid; recovery;
D O I
10.1097/00000542-199903000-00013
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: The subjective and psychomotor effects of remifentanil have not been evaluated. Accordingly, the authors used mood inventories and psychomotor tests to characterize the effects of remifentanil Ln healthy, non-dig-abusing volunteers, Alfentanil was used as a comparator drug. Methods: Ten healthy volunteers were enrolled in a randomized, double-blinded, placebo-controlled, crossover trial in which they received an infusion of saline, remifentanil, or alfentanil for 120 min. The age- and weight-adjusted infusions (determined with STANPUMP, a computer modeling software package) were given to achieve three predicted constant plasma levels for 40 min each of remifentanil (0.75, 1.5, and 3 ng/ml) and alfentanil (16, 32, and 64 ng/ml), Mood forms and psychomotor tests were completed, and miosis was assessed, during and after the infusions. In addition, analgesia was tested at each dose level using a cold-presser test. Results: Remifentanil had prototypic mu-like opioid subjective effects, impaired psychomotor performance, and produced analgesia. Alfentanil at the dose range tested had more mild effects on these measures, and the analgesia data indicated that a 40:1 potency ratio, rather than the 20:1 ratio we used, may exist between remifentanil and alfentanil. A psychomotor test administered GO min after the remifentanil infusion was discontinued showed that the volunteers were still Impaired, although they reported feeling no drug effects. Conclusions: The notion that the pharmacodynamic effects of remifentanil are extremely short-lived after the drug is no longer administered must be questioned given our findings that psychomotor effects were still apparent 1 h after the infusion was discontinued.
引用
收藏
页码:718 / 726
页数:9
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