Effect of temperature and cardiopulmonary bypass on the pharmacokinetics of remifentanil |
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| Authors: | Russell D; Royston D; Rees P H; Gupta S K; Kenny GNC |
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| Institution: | University Department of Anaesthesia, Royal Infirmary, Glasgow G31 2ER; Department of Anaesthesia, Harefield Hospital, Harefield, Middlesex UB9 6JH; Glaxo Wellcome Research and Development, Greenford, Middlesex UB6 0HE; Department of Clinical Pharmacology, Glaxo Wellcome Research Institute, North Carolina, USA |
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| Abstract: | Sixteen patients undergoing coronary revascularization requiring
cardiopulmonary bypass received remifentanil 2 micrograms kg-1 or 5
micrograms kg-1 by infusion over 1 min after sternotomy but before
commencing cardiopulmonary bypass, during hypothermic cardiopulmonary
bypass and during cardiopulmonary bypass after rewarming. Hypothermic
cardiopulmonary bypass reduced the clearance of remifentanil by an average
of 20%, and this was attributed to the effect of temperature on blood and
tissue esterase activity. Reductions in arterial pressure occurred with
administration of both doses during normothermia only.
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