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Lunch and Learn
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Saturday, October 2, 2010
11:30AM - 1:00PM
L511
Remifentanyl and Methohexital Administration as Independent, Continuous Infusions: Further Refinement in Short Duration IV Anesthesia
Handouts Not
Currently Available
Theodore J. Grellner, DDS
Private Practice
Tampa, FL
Synopsis
The recent recalls of propofol and the too frequent need for narcotic reversal prior to discharge from shorter procedures suggests a need for alternatives. Consider the use of the drugs remifentanyl and methohexital via separate continuous infusions. Individual administration of these two ultra-short acting agents results in a smooth anesthetic with a more rapid recovery.
Learning Objectives
At the conclusion of this presentation, participants should be able to:
- Identify how to effectively administer a potent, ultra-short acting narcotic know to cause apnea when bolused, with an ultra-short acting barbiturate that can potentiate the incidence of brief apnea. Upon learning how to concurrently administer these agents as well as airway considerations that must be addressed to use this technique safely, he/she will enjoy an anesthetic technique that may be smoother with a more rapid recovery than he/she has experienced to date; and
- To be able to administer Ultiva (remifentanyl) and methohexital (Brevital) as separate continuous infusions with the goal of customizing and controlling the administration of each drug based on the needs of each patient. The participant will understand that this method of administration changes the effective dosing of these drugs from an on-off type of "gas pedal" to one more akin to the accelerator in our vehicles. The ability to increase or decrease dosing in increments as needed renders a much more controllable, continuous anesthetic. The participant will understand that a gradual decrease in the administration of these ultra-short acting agents (a slow "letting-up" of the accelerator) will result in a lesser need for "braking" as provided by reversal agents.