Abstract：
:Opioids decrease the sympathetic and somatic responses to noxious stimulation and can be given in high doses without negative inotropic effects, even in patients with impaired cardiac function. With currently available opioids, precise titration of dose to effect is difficult, and high doses result in drug accumulation and prolonged respiratory depression. Remifentanil is a new synthetic opioid with direct action on mu-opioid receptors. It has a rapid onset and short latency to peak effect. It is rapidly inactivated by esterases in both blood and tissues, resulting in a very short duration of action. The context-sensitive half-life remains very short (3 to 4 minutes), independent of the duration of infusion. These characteristics facilitate titration of dose to effect and also allow the use of very high doses (ED99) without prolonging recovery from its effects. The duration of action of remifentanil has been found to be short, even in patients with renal or hepatic failure, although only low doses have been used in the studies published to date. The hydrolysis of remifentanil produces a metabolite with very weak opioid receptor activity that does not contribute to the effects of remifentanil. Possible disadvantages of the drug include (1) the need to mix the lyophilized drug with a diluent, (2) administration as a continuous infusion, (3) risk of rapid loss of analgesic and anesthetic effects if the infusion is interrupted accidentally, and (4) difficulty in judging the dose of another, longer lasting opioid that will be required to control postoperative pain without producing excessive ventilatory depression. Remifentanil is likely to be more expensive than other opioids, but its use may reduce overall costs if prompt recovery from its effects results in shorter stays in the operating room and recovery units.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Michelsen LG,Hug CC Jrdoi
10.1016/s0952-8180(96)00179-1subject
Has Abstractpub_date
1996-12-01 00:00:00pages
679-82issue
8eissn
0952-8180issn
1873-4529pii
S0952-8180(96)00179-1journal_volume
8pub_type
杂志文章,评审abstract：STUDY OBJECTIVE:To evaluate the effects of alfentanil or lidocaine on the excitatory phenomena (myoclonus, cough, hiccough) caused by methohexital anesthesia and on the hemodynamic changes induced by retrobulbar block. DESIGN:Prospective, randomized, placebo-controlled, double-blind study. SETTING:University-affiliat...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(98)00072-5
更新日期：1998-09-01 00:00:00
abstract：STUDY OBJECTIVE:Erector spinae plane (ESP) block is a novel regional anesthesia technique and gaining importance for postoperative pain management. Since it was first described, the clinicians wonder if this new simple technique can replace paravertebral block (PVB). We aimed to compare the postoperative analgesic effe...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2019.06.036
更新日期：2020-02-01 00:00:00
abstract：STUDY OBJECTIVE:To quantify global coagulation and establish normal ranges for the celite-activated thrombelastograph (TEG) in healthy pediatric patients. DESIGN:Prospective observational study. SETTING:Operating suite of a university-based hospital. PATIENTS:110 healthy pediatric patients in four age groups and 25 ...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/s0952-8180(00)00238-5
更新日期：2001-02-01 00:00:00
abstract：:We anesthesized a patient susceptible to malignant hyperthermia (MH) three different times by epidural anesthesia with different types of local anesthetics. His skinned fiber test showed a marked acceleration of calcium (Ca2+)-induced Ca2+ release (CICR). When ester type local anesthetic was used for ankle contracture...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(95)00204-9
更新日期：1996-03-01 00:00:00
abstract：:We present a case of abrupt hemodynamic and mental status changes that occurred during shoulder surgery. During interscalene anesthesia for rotator cuff repair, there was abrupt onset of altered mental status and hemodynamic changes, which had a variety of possible contributing causes. Complete recovery occurred durin...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(01)00314-2
更新日期：2001-11-01 00:00:00
abstract：:This case describes a postoperative complication after single-lung ventilation in a 10-year-old patient scheduled for scoliosis repair. This patient underwent an anterior thoracoscopic excision of several vertebral discs followed by a posterior double-rod fixation of her spine. The postoperative course was complicated...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(02)00482-8
更新日期：2003-03-01 00:00:00
abstract：PURPOSE:Anesthesiologists are often involved in the early management and resuscitation of patients who have sustained cervical spine injuries (CSIs). The most crucial step in managing a patient with suspected CSI is the prevention of further insult to the cervical spine (C-spine). In this review, important factors rela...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2005.04.003
更新日期：2005-12-01 00:00:00
abstract：:Alzheimer's disease is a form of dementia that is estimated to affect approximately 3 to 4 million Americans. Given the substantial number of people affected with this disease, it is likely that anesthesiologists will encounter many patients with Alzheimer's disease. Questions as to potential problems including inform...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/s0952-8180(02)00483-x
更新日期：2003-02-01 00:00:00
abstract：:The perioperative care system is a continuum that includes preoperative patient evaluation, operating room scheduling, the operation itself, and postoperative care. This costly fast-paced system requires its various components to function efficiently and interact effectively. This review explores the interrelation bet...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2004.10.003
更新日期：2005-06-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the effect of clonidine when added to local anesthetics on duration of postoperative analgesia during retrobulbar block. DESIGN:Prospective, randomized controlled trial. SETTING:Operating room and Postanesthesia Care Unit of a university-affiliated hospital. SUBJECTS:80 ASA physical statu...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2010.12.014
更新日期：2011-08-01 00:00:00
abstract：:Oxymetazoline nasal spray is a potent alpha 1-adrenergic agonist commonly used to vasoconstrict blood vessels in the nasal mucosa. In this incident, oxymetazoline nasal spray 0.025% was administered to a 2-year-old patient during general anesthesia for nasal endoscopy. Severe hypertension with reflex bradycardia progr...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(95)00060-u
更新日期：1995-09-01 00:00:00
abstract：:We report an 11-year-old male with undiagnosed myopathy, who developed cardiac arrest secondary to severe rhabdomyolysis and hyperkalemia following succinylcholine administration. The patient required extracorporeal membrane oxygenation support from which he was eventually weaned successfully. He died eleven days afte...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2003.09.020
更新日期：2004-09-01 00:00:00
abstract：:A case of a 49 year old man with a giant basilar artery aneurysm requiring rapid ventricular pacing is presented. Rapid ventricular pacing decreased aneurysm size and increased operative exposure, which aided surgical decision making. It also provided decreased wall tension in the aneurysm. ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2012.04.013
更新日期：2012-12-01 00:00:00
abstract：STUDY OBJECTIVE:The aim of the study was to compare the incidence of the use of additional uterotonics before and after the change of carbetocin to oxytocin for the prevention of postpartum hemorrhage after cesarean delivery in women with severe preeclampsia. DESIGN:This was an observational retrospective before-and-a...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.08.017
更新日期：2016-12-01 00:00:00
abstract：STUDY OBJECTIVE:To ascertain if coughing during emergence from general anesthesia can be suppressed with a modified endotracheal tube. DESIGN:Randomized, double-blind, controlled study. SETTING:Operating rooms at a university hospital. PATIENTS:46 adult ASA physical status I, II, and III patients requiring elective ...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(01)00299-9
更新日期：2001-09-01 00:00:00
abstract：OBJECTIVES:To determine the psychometric outcomes of patients participating in an extensive patient-centered verification process before receiving sedation for regional anesthesia. DESIGN:Survey. SETTING:Perioperative areas of university-affiliated hospital. PATIENTS:Two hundred eligible patients scheduled for elect...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2014.10.009
更新日期：2015-05-01 00:00:00
abstract：:Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variati...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2017.04.017
更新日期：2017-08-01 00:00:00
abstract：INTRODUCTION:There have been numerous reports studying the effect of neuraxial analgesia on breastfeeding success, but the results are inconsistent. METHODS:We performed a literature search in various databases for studies comparing neuraxial analgesia to non-neuraxial or no analgesia. Outcomes were the percentage of ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2020.110105
更新日期：2021-02-01 00:00:00
abstract：:The neurologic implications of diabetic hyperglycemia depend on whether the ischemic insult is permanent or temporary. Laboratory studies show that following permanent focal ischemia, a situation analogous to stroke, diabetic hyperglycemia is protective in the penumbral region, whereas it may slightly increase infarct...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/s0952-8180(97)00021-4
更新日期：1997-06-01 00:00:00
abstract：STUDY OBJECTIVE:Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperati...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2015.10.017
更新日期：2016-03-01 00:00:00
abstract：:The right heart and great veins can be the harbinger of septic and aseptic thromboemboli, which can result in a spectrum of clinical syndromes. This report presents five distinct clinical scenarios of thromboembolization, the occurrence of which in the central circulation resulted in life-threatening sepsis and hemody...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/0952-8180(93)90071-l
更新日期：1993-11-01 00:00:00
abstract：STUDY OBJECTIVE:Evaluate feasibility of 1-day OR management course for anesthesiology residents and determine if course content increases trust in OR management science. DESIGN:Pre- and post-course survey evaluations. SETTING:OR management course. PATIENTS:University of Florida anesthesiology residents. INTERVENTIO...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2018.12.045
更新日期：2019-08-01 00:00:00
abstract：STUDY OBJECTIVES:To study the effect of tracheal intubation or laryngeal mask airway (LMA) insertion on intraocular pressure (IOP) in strabismus patients undergoing balanced anesthesia with sevoflurane and remifentanil. DESIGN:Open, prospective, randomized study. SETTING:Tertiary care academic medical institution. P...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(01)00259-8
更新日期：2001-06-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate airway changes in patients undergoing surgery in the prone position. DESIGN:Single-arm observational study. PATIENTS:Patients between 18 to 65 years old, scheduled for prone spinal surgery; 74 patients were enrolled and 54 patients were analyzed. INTERVENTION:The initial airway examinatio...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2014.04.010
更新日期：2014-12-01 00:00:00
abstract：STUDY OBJECTIVE:To compare a multiport, firm-tipped, close-ended, epidural catheter (Portex catheter) with a uniport, open-ended, soft-tipped, wire-reinforced catheter (Arrow catheter) in obstetric patients. STUDY DESIGN:Prospective data collection for intradepartmental quality assurance. SETTING:Obstetric unit in a ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(00)00116-1
更新日期：2000-03-01 00:00:00
abstract：:A 3-year-old girl presented for routine closure of her tracheostomy site. She was intubated easily for the procedure, and the wound was closed with a drain in place. In recovery, the mother noticed fullness in the patient's submandibular region, and on examination, the girl had subcutaneous emphysema in the neck bilat...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.01.033
更新日期：2016-06-01 00:00:00
abstract：STUDY OBJECTIVE:To compare the ease of cannulation, success/failure rate, and complication rate between ulnar and radial arteries. DESIGN:Randomized, controlled study. SETTING:Operating room. PATIENTS:100 ASA physical status I, II, and III patients undergoing general anesthesia and requiring arterial cannulation. I...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2006.10.012
更新日期：2007-05-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate patient acceptability of continued versus divided anesthetic care. DESIGN:Patient satisfaction ratings with continuous and divided anesthetic care were assessed by patient questionnaire. In addition, the effect of training anesthesia personnel in communication regarding divided anesthesia c...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2006.04.004
更新日期：2007-02-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether our institutional insulin management (modified Atlanta) protocol is efficient and safe in controlling blood glucose levels in the perioperative period in surgical patients undergoing tumor hepatectomy. DESIGN:Retrospective study. SETTING:Large community hospital. PATIENTS:20 cons...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2008.09.006
更新日期：2009-08-01 00:00:00
abstract：PURPOSE:The aim of this study was to evaluate the effect of neuraxial blocks on surgical blood losses and on the number of patients requiring blood transfusion. METHODS:A search of the American National Library of Medicine's PubMed up to November 12, 2004, was performed. Twenty-four studies could be kept for analysis....
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,meta分析
doi：10.1016/j.jclinane.2005.08.013
更新日期：2006-03-01 00:00:00
