Remifentanil and the brain
V Fodale1, D Schifilliti, C Praticò
1Department of Neuroscience, Psychiatric and Anesthesiological Sciences, University of Messina, Messina, Italy. vfodale@unime.it
Acta Anaesthesiologica Scandinavica
|February 14, 2008
Summary
Remifentanil, an opioid used in neuroanesthesia, may have toxic effects on the ischemic brain. This review examines its impact on the central nervous system to ensure patient safety and improve outcomes.
Area of Science:
- Neuroscience
- Anesthesiology
- Pharmacology
Background:
- Remifentanil is an ultra-short-acting opioid frequently used in neuroanesthesia and neurointensive care.
- Concerns exist regarding its potential neurotoxicity, particularly in ischemic brain conditions.
- Understanding its central nervous system effects is critical for safe clinical application.
Purpose of the Study:
- To review current information on remifentanil's effects on the central nervous system.
- To evaluate its safety profile in neuroanesthesia and neurocritical care settings.
Main Methods:
- A systematic literature search of MEDLINE was conducted.
- The search focused on studies published within the last seven years concerning remifentanil and brain function.
- Information on various neurological parameters was synthesized.
Main Results:
- Remifentanil influences cerebral metabolism, electroencephalogram, and motor-evoked potentials.
- Effects on cerebral blood flow, intracranial pressure, and cerebrovascular reactivity were analyzed.
- Data on analgesia, hyperalgesia, neuroprotection, neurotoxicity, and hypothermia were considered.
Conclusions:
- Comprehensive knowledge of remifentanil's impact on brain function is essential.
- This knowledge is crucial for optimizing anesthesia practices and enhancing patient safety in neurocritical care.
- Improved understanding can lead to better patient outcomes.
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