Effects of continuous remifentanil administration on intra-operative subcutaneous tissue oxygen tension

Kabon, B; Kugener, A; Gruenberger, T; Niedermayr, M; Fleischmann, E; Freissmuth, M; Kurz, A (2007). Effects of continuous remifentanil administration on intra-operative subcutaneous tissue oxygen tension. Anaesthesia, 62(11), pp. 1101-9. Oxford: Wiley-Blackwell 10.1111/j.1365-2044.2007.05228.x

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Surgical stress response markedly increases sympathetic nerve activity and catecholamine concentrations. This may contribute to peripheral vasoconstriction, reduced wound perfusion and subsequent tissue hypoxia. Opioids are known to depress the hypothalamic-adrenal response to surgery in a dose-dependent manner. We tested the hypothesis that continuous remifentanil administration produces improved subcutaneous tissue oxygen tension compared to fentanyl bolus administration. Forty-six patients undergoing major abdominal surgery were randomly assigned to receive either fentanyl bolus administration or continuous remifentanil infusion. Mean subcutaneous tissue oxygen values over the entire intra-operative period were significantly higher in the remifentanil group, when compared to the fentanyl group: 8 (2) kPa vs 6.7 (1.5) kPa, % CI difference: - 2.3 kPa to - 0.3 kPa, p = 0.013. Continuous intra-operative opioid administration may blunt vasoconstriction caused by surgical stress and adrenergic responses more than an equi-effective anaesthetic regimen based on smaller-dose bolus opioid administration.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Kabon, Barbara, Kugener, André, Kurz, Andrea

ISSN:

0003-2409

ISBN:

17924889

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 14:58

Last Modified:

05 Dec 2022 14:18

Publisher DOI:

10.1111/j.1365-2044.2007.05228.x

PubMed ID:

17924889

Web of Science ID:

000250012500004

URI:

https://boris.unibe.ch/id/eprint/24882 (FactScience: 53566)

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