Remifentanil for analgesia-based sedation in the intensive care unit.

Abstract:

:Providing effective analgesia and adequate sedation is a generally accepted goal of intensive care medicine. Due to its rapid, organ independent and predictable metabolism the short acting opioid remifentanil might be particularly useful for analgesia-based sedation in the intensive care unit (ICU). This hypothesis was tested by two studies in this issue of Critical Care. The study by Breen et al. shows that remifentanil does not exert prolonged clinical effects when continuously infused in renal failure patients, although the weak acting metabolite remifentanil acid accumulates. The study by Muellejans et al. reports a multicenter trial comparing a remifentanil versus a fentanyl based regimen in ICU patients. With both substances a target analgesia and sedation level was reached, and no major differences were found when frequent assessments of the sedation level and according readjustments of doses were performed. These results are in accordance with other studies suggesting that the adherence to a clear analgesia-based sedation protocol might be more important then the choice of medications itself.

journal_name

Crit Care

authors

Kuhlen R,Putensen C

doi

10.1186/cc2421

keywords:

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

13-4

issue

1

eissn

1364-8535

issn

1466-609X

pii

cc2421

journal_volume

8

pub_type

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