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Safety and effectiveness of analgesia with remifentanil for percutaneous transhepatic biliary drainage.

AbstractOBJECTIVE:
The purpose of this study was to evaluate the safety and effectiveness of analgesia with remifentanil for percutaneous transhepatic biliary drainage.
SUBJECTS AND METHODS:
Analgesia for percutaneous transhepatic biliary drainage was induced with remifentanil in 186 patients over a 1-year period. Remifentanil was administered IV with an infusion pump at 0.1 microg/kg/min as the usual dose and 0.15 microg/kg/min as the maximal dose. Selected patients with severe anxiety also received a 1-mg bolus of midazolam. Vital signs, sedation levels, and side effects were checked every 5 minutes during the procedure and recovery. The patients scored their pain subjectively on an 11-point numerical rating scale.
RESULTS:
The mean total dose of remifentanil was 116.3 microg (range, 32.5-200 microg). Midazolam was administered to 15 patients. Transient bradycardia occurred in 19 patients (10%). Hypotension did not develop in any patient. Respiratory depression occurred in four patients (2%). An appropriate level of sedation was obtained in 182 patients (98%), the modified Ramsay score being 2 (n = 164, 88%) or 3 (n = 18, 10%). Forty-nine of the patients (26%) indicated no pain (numeric rating, 0), 120 (64%) indicated mild pain (numeric rating, 1-3), and 16 (9%) indicated moderate pain (numeric rating, 4-6). One patient (1%) indicated severe pain (numeric rating, 7).
CONCLUSION:
Remifentanil is safe and highly effective for pain control during percutaneous transhepatic biliary drainage. This drug is a suitable option for analgesia during painful interventional radiology procedures.
AuthorsNam Sun Park, Jae-Ik Bae, Auh Whan Park, Je Hwan Won, Hyun Seok Lee
JournalAJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 192 Issue 5 Pg. 1430-3 (May 2009) ISSN: 1546-3141 [Electronic] United States
PMID19380573 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Analgesics, Opioid
  • Piperidines
  • Remifentanil
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid (administration & dosage, adverse effects)
  • Biliary Tract Diseases (therapy)
  • Drainage (methods)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Piperidines (administration & dosage, adverse effects)
  • Radiography, Interventional
  • Remifentanil
  • Safety
  • Treatment Outcome

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