Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2015
Randomized Controlled TrialEffects of remifentanil on esophageal motility: a double-blind, randomized, cross-over study in healthy volunteers.
Recent studies have shown that remifentanil increases the risk of aspiration and induces subjective swallowing difficulties. The mechanisms are not completely understood. Here, we investigated whether remifentanil impairs esophageal motility and hypothesized that this is one possible underlying mechanism. Naloxone was used to evaluate whether the effects of remifentanil are mediated through opioid receptors. We also examined subjective swallowing difficulties and the influence of metoclopramide on remifentanil-induced effects. ⋯ Remifentanil induces dysfunction of esophageal motility; this may contribute to the elevated risk of regurgitation and aspiration.
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Acta Anaesthesiol Scand · Oct 2015
Randomized Controlled TrialA randomized clinical trial of the effects of ultra-low-dose naloxone infusion on postoperative opioid requirements and recovery.
Tolerance to remifentanil during sevoflurane anesthesia may increase postoperative analgesic requirements. Low-dose naloxone not only has been shown to block the development of acute opioid tolerance but also to ameliorate undesired opioid-induced side effects. We hypothesized that naloxone prevents the acute opioid tolerance produced by a large dose of remifentanil, and reduces the incidence of opioid-induced side effects. ⋯ Naloxone infusion prevented the acute opioid tolerance, provided a quicker recovery of bowel function, and reduced the length of hospital stay after open colorectal surgery.