Safety and efficacy of remifentanil in craniosynostosis repair in childrenless than 1 year old

Few studies on analgesia with remifentanil (Rf) in children are available, and there are no data on the use of this drug in pediatric neurosurgery. Rf is a new mu -receptor opioid agonist, acting through the activation of pai n inhibitory mechanisms. We conducted a prospective trial on the analgesic effects of Rf in 20 children less than 1 year of age undergoing a neurosurg ical procedure for craniosynostosis repair. Rf was administered at doses of 0.25 mug/kg/min, by continuous infusion, 1 h after admission to the pediat ric intensive care unit (PICU). The treatment was prolonged for 12 h after the operation. The postoperative pain was evaluated in our PICU, comparing the changing of behavioral (AFS and CHEOPS score) and hemodynamic (heart ra te, respiratory rate, systolic and diastolic blood pressure, oxygen saturat ion, O-2 and CO2 partial pressure) parameters, before and after treatment w ith Rf. This drug showed a satisfactory pain control in all the children tr eated. No significant side effects were noticed, except for one episode of urinary retention. In conclusion, Rf appears to be safe and effective for t he treatment of acute pain in the very young child submitted to craniosynos tosis repair. Copyright (C) 2000 S. Karger AG,Basel.