Minimizing stress with remifentanil in a patient with Takotsubo undergoing ophthalmic surgery

Sbaraglia Fabio, MD; Garra Rossella, MD; De Riso Mariella, MD; Continolo Nicola, MD; Sammartino Maria, MD

doi:10.5055/jom.2016.0314

Authors

Sbaraglia Fabio, MD
Garra Rossella, MD
De Riso Mariella, MD
Continolo Nicola, MD
Sammartino Maria, MD

DOI:

https://doi.org/10.5055/jom.2016.0314

Keywords:

remifentanil, Takotsubo, monitored anesthesia care, sedation, cataract, critical patient

Abstract

Anesthesiological management of patients with Takotsubo syndrome (TTS) is a challenge of questions related to physiopathology, prognosis, and trigger causes. Relative rarity of this disease and lack of wide literature do not allow to state any negative or positive effect of the variety of drugs available for anesthesia. The authors report a case of a woman with a clear diagnosis of TTS and anxiety disorder, who underwent to cataract extractions at both eyes at two different times. Clinical management is described, from preoperative assessment until discharge of the patient. In both cases, surgery was successfully performed using remifentanil Target Controlled Infusion sedation in spontaneous ventilation. In this article, the authors suggest the possible cardio-protective role of remifentanil in this kind of pathology, focusing on its advantageous sedating action that guarantees a stress-free condition, while maintaining control on respiratory drive.

Author Biographies

Sbaraglia Fabio, MD

Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy

Garra Rossella, MD

Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy

De Riso Mariella, MD

Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy

Continolo Nicola, MD

Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy

Sammartino Maria, MD

Adjunct Professor, Department of Anesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy

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