TY  - JOUR
A1  - Breen, Des
A1  - Wilmer, Alexander
A1  - Bodenham, Andrew
A1  - Bach, Vagn
A1  - Bonde, Jan
A1  - Kessler, Paul
A1  - Albrecht, Sven
A1  - Shaikh, Soraya
T1  - Offset of pharmacodynamic effects and safety of remifentanil in intensive care unit patients with various degrees of renal impairment
T2  - Critical care
N2  - Introduction: This open label, multicentre study was conducted to assess the times to offset of the pharmacodynamic effects and the safety of remifentanil in patients with varying degrees of renal impairment requiring intensive care.
Methods: A total of 40 patients, who were aged 18 years or older and had normal/mildly impaired renal function (estimated creatinine clearance ≥ 50 ml/min; n = 10) or moderate/severe renal impairment (estimated creatinine clearance <50 ml/min; n = 30), were entered into the study. Remifentanil was infused for up to 72 hours (initial rate 6–9 μg/kg per hour), with propofol administered if required, to achieve a target Sedation–Agitation Scale score of 2–4, with no or mild pain.
Results: There was no evidence of increased offset time with increased duration of exposure to remifentanil in either group. The time to offset of the effects of remifentanil (at 8, 24, 48 and 72 hours during scheduled down-titrations of the infusion) were more variable and were statistically significantly longer in the moderate/severe group than in the normal/mild group at 24 hours and 72 hours. These observed differences were not clinically significant (the difference in mean offset at 72 hours was only 16.5 min). Propofol consumption was lower with the remifentanil based technique than with hypnotic based sedative techniques. There were no statistically significant differences between the renal function groups in the incidence of adverse events, and no deaths were attributable to remifentanil use.
Conclusion: Remifentanil was well tolerated, and the offset of pharmacodynamic effects was not prolonged either as a result of renal dysfunction or prolonged infusion up to 72 hours.
KW  - analgesia based sedation
KW  - critical care
KW  - offset times
KW  - pharmacodynamics
KW  - remifentanil
KW  - renal function
KW  - safety
Y1  - 2003
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/4343
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30-11487
SN  - 1466-609X
SN  - 1364-8535
N1  - Copyright: © Breen et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. 2004
VL  - 8
IS  - 1
SP  - R21
EP  - R30
PB  - BioMed Central ; Springer
CY  - London ; Berlin ; Heidelberg
ER  -