Experience with remifentanil in a burns-care unit

During the consecutive treatment of severely burned patients, frequent peri ods of pain have been recorded. Therefore the use of potential short acting analgetic drugs are essential for the pain therapy during these periods. R emifentanil, a short acting opioid appears to have a promising profile of a ction for this application. Therefore the continuous administration of remi fentanil for long-term analgesia on an intensive burn care unit was evaluat ed. For an evaluation period of 4 months, 31 severely burned patients were trea ted using remifentanil for analgesia. The total 265 of patient days was obs erved (mean 9 days per patient; min 2, max 24), We observed the whole treat ment period starting with emergency care, intensive care as well as intraop erative treatment, The mean dosage necessary was 0.5 (min 0.1 - max 5) mg/h , In non-intubated patients (mean administered dose: 0.3 mg/h, min: 0.1 mg/ h, max: 1.5 mg/h) no intubation or mechanical ventilation was necessary as the result of an opiate-overdosage. The mean cumulative dosage per day was 11.96 mg/24h and reached up to 153 mg/24h, No complications were observed d ue to the use of remifentanil, A sufficient analgesia could be achieved eve n though tachiphylaxis was observed, Due to its short time of action remifentanil was without any complication i n intubated spontaneous breathing as well as in not-intubated patients in a critical care environment for analgesia of short but extremely painful per iods. Additionally, remifentanil has been used successfully for intraoperat ive analgesia even after longterm administration. In summary remifentanil s eems to be a valuable drug for long-term administration in the management o f intubated and not-intubated patients on a burns care unit.