The use of remifentanil to facilitate smooth emergence from anaesthesia

The use of remifentanil to facilitate smooth emergence from anaesthesia

Published: 14 Apr 2013

© Anaesthesia Cases / 2013-0022 / ISSN 2396-8397

Authors

Dr Ming Wilson [1]
Dr Cally Burnand [2]
  • [1] Specialist Registrar, Anaesthesia, Salford Royal Hospital, Manchester, United Kingdom
  • [2] Consultant, Anaesthesia, Salford Royal Hospital, Manchester, United Kingdom

Summary

A 52-year-old patient with hereditary haemorrhagic telangiectasia presented with profound epistaxis requiring surgery. The patient was at high risk of rebleeding into the airway after achieving surgical haemostasis. Remifentanil is known to facilitate smooth emergence from anaesthesia, particularly in situations where coughing or straining on a tracheal tube could exacerbate bleeding. Remifentanil would normally be commenced at induction of anaesthesia or immediately after induction. In this case, we descibe the management of such a patient using remifentanil only at the end of the operation, to facilitate a safe extubation. 

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