Background Previous studies have reported conflicting results concerning the influence of age and gender on pharmacokinetics pharmacodynamics fentanyl, alfentanil, sufentanil. The aim this study was to determine new short-acting opioid remifentanil. Methods Sixty-five healthy adults (38 men 27 women) ages 20 85 y received remifentanil by constant-rate infusion 1 8 micrograms.kg-1.min-1 for 4 min. Frequent arterial blood samples were drawn assayed concentration. electroencephalogram used as a...

Remifentanil (GI87084B) is a new short-acting opioid with unique ester structure. Metabolism of remifentanil by hydrolysis results in very rapid elimination. The aim this study was to characterize detail the pharmacokinetic profile healthy male volunteers.Ten adult volunteers received zero-order infusion at doses ranging from 1 8 micrograms.kg-1.min-1 for 20 min. Frequent arterial blood samples were drawn and analyzed gas chromatographic mass spectroscopy determine concentrations. raw data...

Remifentanil is an esterase-metabolized opioid with a rapid clearance. The aim of this study was to contrast the pharmacokinetics and pharmacodynamics remifentanil alfentanil in healthy, adult male volunteers.Ten volunteers received infusions on separate sessions using randomized, open-label crossover design. Arterial blood samples were analyzed determine drug concentrations. electroencephalogram employed as measure effect. characterized moment analysis, nonlinear mixed effects model...

Background Remifentanil is a short-acting opioid whose pharmacokinetics have been characterized in detail. However, the impact of obesity on remifentanil has not specifically examined. The goal this study was to investigate influence body weight pharmacokinetics. Methods Twelve obese and 12 matched lean subjects undergoing elective surgery received 1-min infusion after induction anesthesia. Arterial blood samples were collected for determination concentrations. Each subject's pharmacokinetic...

Background Characterizing drug interactions using a response surface allows for the determination of interaction over complete range clinically relevant concentrations. Gathering data necessary to create this is difficult do in clinical setting and requires use volunteer experiments with surrogate noxious stimuli adequately control process collection. The pharmacodynamic synergy opioids hypnotics was investigated study paradigm. Methods Twenty-four subjects (12 male, 12 female) were studied...

Background The pharmacology of propofol infusions administered for long-term sedation intensive care unit (ICU) patients has not been fully characterized. aim the study was to develop dosing guidelines ICU based on an integrated pharmacokinetic-pharmacodynamic model in patients. Methods With Institutional Review Board approval, 30 adult male medical and surgical were given target-controlled sedation, adjusted maintain a Ramsay scale score 2-5. Propofol administration first 20 subjects...

Propofol is a common sedative hypnotic for the induction and maintenance of anesthesia. Clinicians typically moderate dose propofol or choose different in setting severe intravascular volume depletion. Previous work has established that hemorrhagic shock influences both pharmacokinetics pharmacodynamics rat. To investigate this further, authors studied influence on pharmacology swine isobaric hemorrhage model.After approval from Animal Care Committee, 16 were randomly assigned to control...

Background Previous work has demonstrated that ongoing hemorrhagic shock dramatically alters the distribution, clearance, and potency of propofol. Whether volume resuscitation after restores drug behavior to baseline pharmacokinetics pharmacodynamics remains unclear. This is particularly relevant because patients suffering from are typically resuscitated before surgery. To investigate this, authors studied influence an isobaric bleed followed by crystalloid on propofol in a swine model. The...

Combining a hypnotic and an analgesic to produce sedation, analgesia, surgical immobility required for clinical anesthesia is more common than administration of volatile anesthetic alone. The aim this study was apply response surface methods characterize the interactions between remifentanil sevoflurane.Sixteen adult volunteers received target-controlled infusion (0-15 ng/ml) inhaled sevoflurane (0-6 vol%) at various target concentration pairs. After reaching pseudo-steady state drug levels,...

In Brief INTRODUCTION: this study, we explored how a set of remifentanil-propofol response surface interaction models developed from data collected in volunteers would predict responses to events patients undergoing elective surgery. Our hypotheses were that these patient population's loss and return responsiveness the presence or absence laryngoscopy pain after METHODS: Twenty-one enrolled. Anesthesia consisted remifentanil propofol infusions fentanyl boluses. Loss responsiveness,...

In this study we used responses from 174 public-sector and private-sector employees to assess differences in perceived job communication formalization, emphasis on objective-oriented results, perceptions of distributive procedural justice, employees' satisfaction with their immediate supervisors. Overall, public similar formalization but they held weaker justice were less satisfied We also discuss other implications, limitations.

In Brief The currently marketed propofol formulation has a number of undesirable properties that are in part function the lipid emulsion formulation, including pain on injection, serious allergic reactions, and support microbial growth. A modified cyclodextrin-based (sulfobutyl ether-β-cyclodextrin) been developed may mitigate some these formulation-dependent problems. However, reformulation alter propofol's pharmacologic behavior. Our aim this study was to compare pharmacokinetics...

Dr. Paul Janssen was the founder of Pharmaceutica and developer over 80 pharmaceutical compounds that proved useful in human, botanical, veterinary medicine. He his coworkers synthesized fentanyl family drugs, many other potent analgesics, droperidol, etomidate, numerous important medicines were extremely psychiatry, parasitology, gastroenterology, cardiology, virology, immunology. Anesthesiology medicine as a whole have benefited great deal from resourcefulness, creativity, entrepreneurial spirit.

Background Opioids are commonly used in conjunction with sedative drugs to provide anesthesia. Previous studies have shown that opioids reduce the clinical requirements of sedatives needed adequate Processed electroencephalographic parameters, such as Bispectral Index (BIS; Aspect Medical Systems, Newton, MA) and Auditory Evoked Potential (AAI; Alaris San Diego, CA), can be intraoperatively assess depth sedation. The aim this study was characterize how addition sufficient change level...

In Brief BACKGROUND: Remifentanil and propofol are increasingly used for short-duration procedures in spontaneously breathing patients. this setting, it is preferable to block the response moderate stimuli while avoiding loss of responsiveness (LOR) intolerable ventilatory depression (IVD). study, we explored selected effects combinations remifentanil-propofol effect-site concentrations (Ces) that lead a esophageal instrumentation (EI), LOR, and/or onset IVD. A secondary aim was use these...

Background Using models of respiratory compromise, loss response to esophageal instrumentation, and responsiveness, the authors explored through simulation published dosing schemes for endoscopy using propofol alone in combination with selected opioids. They hypothesized that would predict adequate conditions instrumentation once drug administration is terminated, rapid return responsiveness minimal compromise. Methods Four regimens or opioids were used probability a 10-min procedure...

Remifentanil is still in its infancy terms of postmarketing development. Its appropriate role modern anesthesia care being defined and reports novel clinical applications for remifentanil are frequently appearing the literature. This review will focus on selected advances our understanding pharmacokinetics pharmacodynamics newly proposed remifentanil.