British journal of anaesthesia
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Clinical Trial Controlled Clinical Trial
Pharmacokinetics of remifentanil and its major metabolite, remifentanil acid, in ICU patients with renal impairment.
The pharmacokinetics of remifentanil, an opioid analgesic metabolized by non-specific esterases, and its principal metabolite, remifentanil acid (RA), which is excreted via the kidneys, were assessed as part of an open-label safety study in intensive care unit (ICU) patients with varying degrees of renal impairment. ⋯ Although RA accumulates in patients with moderate/severe renal impairment, pharmacokinetic modelling predicts that RA concentrations during a 9 microg kg(-1) h(-1) remifentanil infusion for up to 15 days would not exceed those reported in the present study, for which no associated prolongation of mu-opioid effects was observed.
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Sore throat and hoarseness are common complications, but these have not been studied after total i.v. anaesthesia. ⋯ Knowledge of these factors may reduce postoperative throat complications, and improve patient satisfaction.
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Glass bottles are used for the storage of local anaesthetics in the US and are recyclable. Recycling would result in hospital solid waste reduction. ⋯ The recycling of glass is good for the environment through waste reduction and results in small savings to the hospital.