Remifentanil target-controlled infusion: A safe rescue protocol for unexpected severe postoperative pain

Cyrus Motamed, MD; Grégoire Weil, MD; Frederic Deschamps, MD; Valérie Billard, MD

doi:10.5055/jom.2014.0216

Authors

Cyrus Motamed, MD
Grégoire Weil, MD
Frederic Deschamps, MD
Valérie Billard, MD

DOI:

https://doi.org/10.5055/jom.2014.0216

Keywords:

remifentanil, severe postoperative pain, target-controlled infusion, respiratory depression

Abstract

Three cases are reported here in which remifentanil administered as a target-controlled infusion (TCI) was used in Post Anesthesia Care Unit as a fast rescue treatment for acute and unexpected severe postoperative pain, allowing subsequent clinical evaluation and rational titration of analgesia with longer acting opioids. It illustrates the efficacy of this technique to titrate and compensate for variability in opioid requirements. However, its safety requires full knowledge of TCI technique, continuous monitoring of respiratory function, and assisted ventilation equipment immediately available.

Author Biographies

Cyrus Motamed, MD

Anesthesia Department, Institut Gustave Roussy, Villejuif, France.

Grégoire Weil, MD

Anesthesia Department, Institut Gustave Roussy, Villejuif, France

Frederic Deschamps, MD

Interventional Radiology Department, Institut Gustave Roussy, Villejuif, France

Valérie Billard, MD

Anesthesia Department, Institut Gustave Roussy, Villejuif, France

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