[Continuous infusion of low-dose remifentanil for palliation of pain with epidural catheterization].

BACKGROUND: To prospectively determine the safety and effectiveness of continuous infusion of low-dose remifentanil for the reduction of pain in patients for epidural catheterization. METHODS: This study was approved by the institutional review board. Written informed consent was obtained. Fifty two patients (27 men, 25 women, age range 16-96 years, mean age 68 years) were given continuous infusion of various rates of application (none, 0.02, 0.05, and 0.07 microg x kg -1 x hr-1) of remifentanil. Blood pressure, heart rate, pulse oximetry oxygen saturation and respiratory rate were recorded during the procedure of epidural catheterization. Pain score was measured with the visual analogue scale (VAS), and complications including muscle stiffness, nausea and vomiting, and depressed level of consciousness were monitored. RESULTS: Every rate of application, pulse oximetry oxygen saturation and systemic blood pressure were decreased but the reduction was not marked. The muscle stiffness, nausea and vomiting, and depressed level of consciousness were not observed in all the cases. No other serious complications were observed. CONCLUSIONS: Continuous infusion of low-dose remifentanil is a safe and effective method for palliation of pain in epidural catheterization.