Fentanil

PURPOSE: The effects of i.v. remifentanil in combination with an inhaled anesthetic to facilitate tracheal extubation of deeply anesthetized adults after otologic surgery are investigated. METHODS: Fifty patients undergoing middleear surgery were recruited for the study. All patients were administered deep anesthesia (i.v. fentanil, propofol, and mivacurium) and intubated, with subsequent administration of inhaled sevoflurane for anesthesia maintenance. Prior to endotracheal tube removal, the patients received i...

The aim of this study is the analysis of the beneficial impact of using opioid receptor antagonist associated to opioid analgesic on the quality of life in patients suffering from chronic non-cancer pain. We recruited 60 patients suffering from osteo-articular diseases who were randomized into two groups of treatment. The group A was treated with the association of opioid receptor antagonist and opioid agonist, represented by Oxycodone. The group B was treated with the opioid analgesics Oxycodone, transdermal Fentanil, and Hidromorphone, without the opioid antagonist...

BACKGROUND: In recent years, laser systems with higher wavelengths, associated with new optical fibers, have shown excellent short-term results in treating saphenous veins and reducing the side effects and, in particular, the postoperative pain. However, if the patients are not anesthetized, they may feel pain even when using low energy with the high-wavelength laser; the only tumescent local anesthesia often does not guarantee a complete pain control during endovenous laser ablation (EVLA)...

Introduction. It is a consensus that the postoperative cognitive function is impaired in elderly patients after general anaesthesia, and such category patient takes more time to recover. Xenon is a noble gas with anesthetic properties mediated by antagonism of N-methyl-D-aspartate receptors. With a minimum alveolar concentration of 0.63, xenon is intended for maintaining hypnosis with 30% oxygen. The fast recovery after xenon anaesthesia was hypothesized to be advantageous in this scenario. Case Presentation...

The study reports the dynamic of ICP, CPP and systemic hemodynamic rates during midazolam induction of anesthesia in patients with traumatic brain compression. Patients who need urgent surgery to eliminate brain compression of various degrees generally have intracranial hypertension. Midazolam administration decreases ICP by 22% from baseline under condition of stable hemodynamic and CPP. Depolarizing neuromuscular blocking agents' administration, mechanical ventilation and tracheal intubation lead to ICP elevation and CPP decreasing...

The clinical presentation of a subarachnoid block (SAB) is dependent upon the intrathecal spread of local anesthetic (LA). Intrathecal distribution depends on the chemical and physical characteristics of LA, puncture site, technique used, patient anatomical characteristics and hydrodynamic properties of cerebrospinal fluid. We tried to determine whether a combined glucose/LA solution can render a clinically significant difference in sensory block distribution and motor block intensity.This was a controlled, randomized and double blinded study...

THE PURPOSE OF THE STUDY: Evaluation of the effectiveness and safety of analgesics use before planned tracheal intubation in newborns. MATERIALS AND METHODS: The study was carried out in 3 groups of full-term newborns: a "control" group(n=19, intravenous atracurium and midazolam before intubation), a "fentanyl" group (n=22, intravenous fentanyl 3mkg/kg together with muscle relaxant and benzodiazepines), a "sevoflurane" group (n=15, intubation under sevoflurane inhalation)...

OBJECTIVE: To observe the effects of short-term exposure to opioid analgesics on human sperm motility. METHODS: Twenty normal semen samples were collected, each divided into 19 groups, one as the control and the others treated in vitro with six opioid analgesics at three different concentrations, respectively, and sperm motility was assessed by computer-assisted sperm analysis at 15 min, 2 h and 4 h. RESULTS: Compared with the control group, fentanyl, alfentanil and sufentanil at 1 x 10(-5), 2 x 10(-3) and 0...

BACKGROUND: Despite possible advantages, few surgical series report specifically on awake craniotomy for intrinsic brain tumors in eloquent brain areas. OBJECTIVES: Primary: To evaluate the safety and efficacy of fully awake craniotomy (FAC) for the resection of primary supratentorial brain tumors (PSBT) near or in eloquent brain areas (EBA) in a developing country. Secondary: To evaluate the impact of previous surgical history and different treatment modalities on outcome...

BACKGROUND AND OBJECTIVES: It is a well-established fact today that the technique of choice for elective cesarean delivery is regional anesthesia. However, in patients with intracranial hypertension and central nervous system infection, this technique should be avoided. This paper aimed at reporting the anesthetic management of a pregnant patient with intracranial hypertension due to tuberculous meningitis submitted to elective cesarean delivery. CASE REPORT: Caucasian patient, 32 years old, 1...

OBJECTIVE: To evaluate the nonopioid analgesic drug effect and influence on serum cytokine and postoperative epidural analgesia. METHODS: With informed consent, fifty patients underwent the hysterectomy with double catheter epidural anesthesia and were assigned to intramuscular injection analgesia group (group V) and epidural analgesia group which was randomized into four groups: Bupivacaine group (group I), Bupivacaine + Fentanil group (group II), Bupivacaine + Verapamil group (group III) and Bupivacaine + Fentanil + Verapamil (group IV)...

BACKGROUND: Pain is the most common discomfort experienced by children undergoing major operations. It is most often not adequately treated because of inexperience and unfounded fears related to the use of opioid drugs. In adults, patient-controlled analgesia (PCA) is widely administered, while in children, its use with opioid drugs is still under evaluation for safety and efficacy. OBJECTIVES: The objective of the study is to evaluate the safety and efficacy of an opioid drug (fentanil) administered by PCA associated with a sedative-adjuvant drug (midazolam) administered by continuous infusion in children having undergone major neurosurgical procedures...

The sublingual administration of opioid analgesics has been a mainstay in the pain management of homebound dying hospice patients who are no longer able to swallow. It is also a potentially useful route of administration in other situations in which the oral route is not available and other routes are impractical or inappropriate. Potential advantages of the sublingual route include rapid analgesic onset and avoidance of hepatic first-pass metabolism. Pharmacokinetic and pharmacodynamic studies have yielded widely disparate data on sublingual morphine...

A sensitive, semiautomated method for the analysis of several fentanils and fentanil metabolites in human urine is described. This method uses solid-phase extraction of urine samples followed by liquid chromatography-atmospheric pressure ionization-tandem mass spectrometry. Isotopically labeled internal standards were included for 6 of the 13 analytes in this study. Estimated detection limits ranged from 3 to 27 pg/mL, and good accuracy and long-term precision were observed in most cases. This method should be useful for the rapid and sensitive screening of human urine samples for a number of fentanils and their metabolites as indicators of exposure...

A decrease of surgical trauma and improvement of anesthesia quality are the key points in quality life improvement after surgical treatment of varicose disease. Two variants of incisions were used: mini approaches of length not more than 20 mm and micro approaches of length to 2 - 3 mm. During surgery instruments of decreased sizes were applied. Direct and distant mini approaches were used for crossectomy. Disjunction of Coccett's perforated veins in trophic disorders was performed through distant mini approach, valvuloplasty of the femoral vein - through two mini approaches...

OBJECTIVES: To analyze the viability of immediate extubation of children after corrective surgery for congenital heart defects with extracorporeal membrane oxygenation using an anesthetic technique involving caudal morphine, and to study the effect on length of stay in the pediatric intensive care unit (PICU) or elsewhere in the hospital. MATERIAL AND METHODS: Twenty-nine ASA I-II patients without coagulation alterations undergoing surgery to correct simple heart defects were selected for extubation after surgery...

In 34 patients the abstinence syndrome was treated by hypothermia (HT) with the EEG monitoring. HT was carried out under the general propofol-fentanil anesthesia. HT was achieved in the "Hirana" bath. The temperature was increased gradually by 1 degree C per 5 minutes up to 44 degrees C. EEG was recorded before anesthesia, as well as during and after the procedure. On the initial EEG alpha- and beta-rhythms were predominant. Under the anesthesia both alpha-rhythm frequency and amplitude were enhanced, spikes and wave discharges appeared...

BACKGROUND: Supraventricular tachyarrhythmias (SVTs) represent an intraoperative risk factor that should be always prevented/managed. The commonly used anti-arrhythmic drugs are accompanied by intrinsic hazards, such as pro-arrhythmic and toxic effects or unpredictable onset and duration of action. We underline the therapeutic use of transesophageal atrial pacing (TAP) for the interruption of particular re-entry SVTs occurred during surgical procedures in general anaesthesia. METHODS: Our study was carried out in 25 patients characterized by a personal clinical history of transient tachyarrhythmic episodes, subjected to general anaesthesia obtained by midazolam, propofol, N2O e O2, sevoflurane, fentanil and vecuronium bromide...

Transdermal drug delivery (TDD) is the administration of therapeutic agents through intact skin for systemic effect. TDD offers several advantages over the conventional dosage forms such as tablets, capsules and injections. Currently there are about eight drugs marketed as transdermal patches. Examples of such products include nitroglycerin (angina pectoris), clonidine (hypertension), scopolamine (motion sickness), nicotine (smoking cessation), fentanil (pain) and estradiol (estrogen deficiency). Since skin is an excellent barrier for drug transport, only potent drugs with appropriate physicochemical properties (low molecular weight, adequate solubility in aqueous and non-aqueous solvents, etc) are suitable candidates for transdermal delivery...

OBJECTIVE: To compare the recovery of patients after anesthesia with sevoflurane or propofol during open urological surgery or lumbar column surgery of intermediate duration. PATIENTS AND METHODS: Thirty-six ASA I, II or II patients were enrolled prospectively and randomly assigned to two groups to receive either sevoflurane (n = 19) or proporol (n = 17). Anesthetic induction was accomplished with thiopental, fentanil and vecuronium. During anesthetic maintenance a mixture of 60% nitrous oxide in oxygen plus the drug under study was adjusted to keep blood pressure and/or heart rate within +/- 20% of baseline...