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Use of remifentanil in infants
1Department of Anesthesiology, University of Washington School of Medicine, Seattle, USA.
Paediatric Anaesthesia
|September 22, 1998
Insights
Remifentanil, an ultra-short-acting opioid, showed a short duration of effect in infants with complex medical conditions, even after prolonged infusion. Further research is needed to confirm its potential utility in pediatric critical care.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
- Pharmacology
Background:
- Infants with complex medical issues often require careful anesthetic management.
- Opioid analgesics are crucial for pain and sedation in critically ill infants.
- Remifentanil offers unique pharmacokinetic properties, but its use in neonates and infants with organ dysfunction requires further investigation.
Observation:
- This study observed the use of remifentanil in three infants with significant comorbidities including hepatic failure, cyanotic heart disease, and renal compromise.
- The drug was infused for an extended period of 18 hours.
Findings:
- Despite an 18-hour infusion, remifentanil demonstrated a short duration of opioid effect in these infants.
- This suggests a rapid clearance or metabolism of remifentanil, even in the presence of organ dysfunction.
Implications:
- Remifentanil may be a viable anesthetic option for specific pediatric patients with complex medical problems.
- Its predictable and short duration of action could facilitate faster recovery and extubation.
- Additional studies are essential to establish safety, efficacy, and optimal dosing in this vulnerable population.
Abstract:
We describe the use of remifentanil in three infants with complex medical issues (hepatic failure, cyanotic heart disease and renal compromise). The short duration of opioid effect even after a long period of drug infusion (18 h) suggests this drug may be useful in some infants. Continued study is warranted.