sábado, 14 de febrero de 2015

Consideraciones para el uso de opioides de acción breve en anestesia general

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Consideraciones para el uso de opioides de acción breve en anestesia general
Considerations for the use of short-acting opioids in general anesthesia.
Mandel JE.
J Clin Anesth. 2014 Feb;26(1 Suppl):S1-7. doi: 10.1016/j.jclinane.2013.11.003. Epub 2014 Jan 29.
Abstract
Anesthesiologists play a critical role in facilitating a positive perioperative experience and early recovery for patients. Depending on the kind of procedure or surgery, a wide variety of agents and techniques are currently available to anesthesiologists to administer safe and efficaciousanesthesia. Notably, the fast-track or ambulatory surgery environment requires the use of agents that enable rapid induction, maintenance, and emergence combined with minimal adverse effects. Short-acting opioids demonstrate a safe and rapid onset/offset of effect; that short effect is both predictable and precise. It also ensures easier titration and reduced or rapidly reversed side effects. Due to their distinct pharmacokinetic and pharmacodynamic properties, and, in one case, rapid extra-hepatic clearance of remifentanil, these agents have several applications in general anesthesia.
KEYWORDS: Alfentanil; General anesthesia; Propofol; Remifentanil; Short-acting opioids; Sufentanil; Total intravenous anesthesia
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