The effect of acutely induced hepatic failure on remifentanil and fentanyl blood levels in a pig model

European Journal of Anaesthesiology
G KostopanagiotouV Smyrniotis

Abstract

Opioids and especially fentanyl are widely used during the intensive care unit management of intracranial pressure in fulminant hepatic failure patients as well as during and after liver transplantation. The newer synthetic opioid remifentanil is also increasingly being used in critical care patients. Due to a lack of data relating to the influence of acute hepatic failure on remifentanil and fentanyl pharmacokinetics, this study was designed in order to determine the impact of this condition on the blood levels of these opioids using a pig model. Twenty pigs were randomly assigned to one of two groups: A group with surgically induced acute hepatic failure by hepatic devascularization (acute hepatic failure, n=10) and a control group (SHAM, n=10), subjected to a SHAM operation. Postoperatively, five animals in each group were administered remifentanil (1 microg kg-1 min-1) or fentanyl (0.2 microg kg-1 min-1) by continuous intravenous infusion. Blood samples for determination of drug concentrations were withdrawn at 0 h and 0.5, 1, 5, 7, 9 h after initiation of dosing. Significantly higher blood concentrations were found in animals with acute hepatic failure compared to SHAM-operated animals receiving remifentanil at 5 h (P=0.00...Continue Reading

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Citations

Jul 7, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·L BeydonM Gogny
Jun 9, 2009·Burns : Journal of the International Society for Burn Injuries·Kotaro Kaneda, Tae-Hyung Han
Mar 9, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Hance ClarkeJoel Katz
Jun 19, 2010·Journal of Veterinary Pharmacology and Therapeutics·M Martinez, S Modric
Jul 3, 2016·International Journal of Pharmaceutics·Ornella PiazzaGaetano Lamberti
Aug 2, 2008·Chemical & Pharmaceutical Bulletin·Zhimin ZhaoYoshio Takeda

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