BACKGROUND AND OBJECTIVES Serious functional and structural alterations of gastrointestinal tract are observed in failure of blood supply, leading to gastrointestinal dismotility. Activation of opioid receptors provides cardioprotective effect against ischemia-reperfusion (I/R) injury. The aim of the present study was to determine whether or not remifentanil could reduce I/R injury of small int...

BACKGROUND Bone injury is common in many clinical situations, such as surgery or trauma. During surgery, excessive reactive oxygen species (ROS) production decreases the quality and quantity of osteoblasts. Remifentanil decreases ROS production, reducing oxidative stress and the inflammatory response. We investigated remifentanil's protective effects against H2O2-induced oxidative stress in ost...

Background: The effects of different opioids on postoperative nausea and vomiting (PONV) and pain have not been conclusively determined. The aim of this study was to compare the effects of fentanyl, remifentanil or fentanyl plus morphine on the incidence of PONV and pain in women subjected to cesarean section under general anesthesia. Methods: The study was a randomized clinical trial r...

Editor’s key points † Three patients with an apparently decreased response to remifentanil. † Two of these patients subsequently tested with a step-up infusion of remifentanil. † They had a normal analgesic response but limited respiratory and consciousness responses. † The cause of this impaired effect is not clear. Background. Over a 5 yr period, we have encountered three patients in whom rem...

Background: More procedures are performed in sedation alone or as an adjunct to local anesthesia. Hence, the diversity of the procedures and the patients are increasing along with the need for suitable sedative alternatives. Objective: The purpose of this study was to assess the safety and efficacy of remifentanil monotherapy for procedure sedation. Design: Systematic review of randomised contr...

BACKGROUND Remifentanil, an ultra-short-acting opioid, is used as an on-top analgesic in head trauma patients during transient painful procedures, e.g. endotracheal suctioning, physiotherapy, on the intensive care unit. However, previous studies have shown that opioids may increase intracranial pressure and decrease cerebral blood flow. METHODS The present study investigates the effect of rem...

PURPOSE Prevention of cough during emergence after nasal surgery is important for avoiding surgical site bleeding. We investigated the remifentanil effect-site concentration in 50% (EC50) of the elderly patients undergoing nasal surgery for smooth emergence without cough and compared it with that of adult patients. METHODS Twenty-two elderly (aged 65-80 years) and 25 adult patients (aged 20-6...

BACKGROUND This study was designed to investigate whether stepwise tapering of remifentanil at the end of surgery could decrease postoperative pain scores and requirements of rescue analgesics after remifentanil-desflurane anesthesia in patients with thyroidectomy. METHODS Sixty two patients undergoing thyroidectomy under general anesthesia were randomly allocated into two groups. All patient...

BACKGROUND AND OBJECTIVES The combination of ketamine and remifentanil seems to be associated with better analgesia and duration. The aim of this study was to evaluate whether a ketamine-remifentanil combination promotes improved postoperative analgesia. METHODS Prospective, randomized, double blind study of 40 patients undergoing video laparoscopic cholecystectomy. Anesthesia was performed w...

BACKGROUND The surgical pleth index (SPI) is an index based on changes in plethysmographic characteristics that correlate with the balance between the sympathetic and parasympathetic nervous system. It has been proposed as a measure of the balance between nociception and anti-nociception. The goal of this study was to test whether it could be used to titrate remifentanil in day-case anaesthesia...