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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2024

Open Access 01-12-2024 | Remifentanil | Research

Remifentanil improves left ventricular diastolic parameters in patients with impaired diastolic function: a prospective clinical study

Authors: Özge Köner, Mustafa Aytek Şimşek, Nurcan Kızılcık, Çiğdem Koca, Ayça Türer Cabbar

Published in: BMC Anesthesiology | Issue 1/2024

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Abstract

Background

Left ventricular diastolic dysfunction has a significant impact on perioperative morbidity and mortality, and its incidence is high in elderly individuals. Anesthetic agents may impair diastolic function, which may increase the incidence of perioperative complications. The aim of this prospective, clinical, phase 4 study was to investigate the effects of remifentanil on left ventricle (LV) diastolic function in patients with diastolic dysfunction. The study was performed on 30 spontaneously breathing subjects (aged 60–80 years) with diastolic dysfunction.

Methods

Thirty patients (aged 60–80 years) with diastolic dysfunction scheduled for surgery were recruited between November 2019 and March 2023. Left ventricle function was evaluated once the intravenous remifentanil infusion reached a target-controlled concentration of 2 ng/ml with transthoracic echocardiography. Analysis of systolic function focused on left ventricular ejection fraction and mean mitral annular S velocity (Sm), whereas diastolic function focused on changes in transmitral peak flow (E), E/A, mitral septal and lateral e’ waves, E/e’ ratios and left atrial volume index following remifentanil infusion.

Results

Diastolic function measures of LV (mitral E/e’, septal and lateral e’ waves) statistically significantly improved (E/e’ from 10.6 ± 2.9 cm.sn− 1 to 9.5 ± 2.2 cm.sn− 1; p = 0.006) following remifentanil infusion. Left atrial volume index decreased following remifentanil infusion without statistical significance (from 55 ± 14.4 ml.cm− 2 to 51.6 ± 13.3 ml.cm− 2; p = 0.1). Systolic function (ejection fraction and Sm) did not change following remifentanil infusion.

Conclusions

Remifentanil improves left ventricular diastolic parameters in patients with preexisting diastolic dysfunction. Our study suggests that remifentanil at a plasma concentration of 2 ng.ml− 1 might be used safely in patients with left ventricular diastolic dysfunction.
Appendix
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Metadata
Title
Remifentanil improves left ventricular diastolic parameters in patients with impaired diastolic function: a prospective clinical study
Authors
Özge Köner
Mustafa Aytek Şimşek
Nurcan Kızılcık
Çiğdem Koca
Ayça Türer Cabbar
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2024
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-024-02425-9

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