Masui. The Japanese journal of anesthesiology
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Comparative Study
[Postoperative nausea and vomiting after laparoscopic cholecystectomy under total intravenous anesthesia using propofol combined with fentanyl or pentazocine].
The aim of this study was to compare the incidence of postoperative nausea and vomiting (PONV) in propofol-anesthetized patients receiving either fentanyl or pentazocine as opioid supplement. ⋯ The incidence of PONV in propofol-anesthetized patients receiving pentazocine as opioid supplement is not different from that in patients receiving fentanyl.
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Providing analgesia is the most important, yet the most difficult aspect of remifentanil anaesthesia, as its effect wears off quickly after infusion is terminated. Longer-acting opioids such as morphine and fentanyl must be given well before patients wake up. Bolus administration of fentanyl approximately 20 minutes before the end of surgery may provide adequate analgesia at emergence and tracheal extubation. ⋯ However, in some susceptible patients, even a very low-rate infusion can still cause significant respiratory depression more than 30 minutes after starting infusion. Pulse oximetry is not sensitive enough to detect early ventilatory depression when patients breathe oxygen-enriched air. Without continuous observation by trained anaesthetists, infusion of remifentanil should not be used casually particularly in non-ventilated patients.
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Review Comparative Study
[Pharmacodynamics and pharmacokinetics of remifentanil: overview and comparison with other opioids].
In this review, the authors tried to summarize the characteristics and main differences of remifentanil with other opioids, and to overview its pharmacodynamics and pharmacokinetics. Clearance and volume of distribution of remifentnail are extremely different from other conventional opioids. ⋯ As remifentanil is metabolized by a non-specific esterase, excretion of remifentnil is predictable in basically all patients undergoing general anesthesia and surgery. Therefore, remifentanil is considered to be an optimal opioid as an analgesic combined either with inhalational anesthetics or intravenous hypnotics in balanced general anesthesia.
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Review Case Reports
[Clinical electroencephalographic monitoring of depth of anesthesia].
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Individual variation in the sensitivity to anesthetics induces the delayed awakening and the severe postoperative pain at an inappropriate dose. We designed the study to see the correlation of the individual sensitivity to fentanyl and that to propofol which have different mechanism. ⋯ The correlation of the individual sensitivity to fentanyl and propofol was found in older age groups.