Abstract:
BACKGROUND AND OBJECTIVES:Remifentanil infusion is used as an intraoperative anesthetic for thyroidectomy, but has been associated with acute opioid tolerance and hyperalgesia. A national shortage of remifentanil provided an opportunity to study postoperative pain in patients undergoing thyroidectomy. METHODS:Retrospective review of prospectively collected data from an outpatient surgery center. Primary analysis compared patients treated before and after remifentanil shortage. RESULTS:Median postoperative opioid consumption was 20 morphine milligram equivalents (MMEs) among those treated in the high-dose period and 15 MMEs in the low-dose period. Remifentanil/weight received was a significant predictor of requiring a postoperative narcotic (P = .006). Total non-remifentanil narcotics administered were equivalent but patients in the low dose period received higher amounts of intraoperative long-acting narcotics. CONCLUSIONS:Remifentanil infusion for thyroid surgery is associated with higher postoperative pain and postoperative narcotics requirement. While a hyperalgesia state is possible, shifting of longer-acting narcotics from intraoperative to postoperatively is also supported.
journal_name
J Surg Oncoljournal_title
Journal of surgical oncologyauthors
Wu JX,Assel M,Vickers A,Afonso AM,Twersky RS,Simon BA,Cohen MA,Rieth EF,Cracchiolo JRdoi
10.1002/jso.25746subject
Has Abstractpub_date
2019-12-01 00:00:00pages
1456-1461issue
8eissn
0022-4790issn
1096-9098journal_volume
120pub_type
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journal_title:Journal of surgical oncology
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更新日期:2006-09-01 00:00:00
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