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British Journal of Anaesthesia, 2001, Vol. 87, No. 6 866-869
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

No clinical evidence of acute opioid tolerance after remifentanil-based anaesthesia

L. I. Cortínez, V. Brandes, H. R. Muñoz, M. E. Guerrero and M. Mur

Hospital Clínico Universidad Católica de Chile, Departamento de Anestesiología, Marcoleta 367, PO Box 114-D, Santiago, Chile*Corresponding author

We have prospectively assessed whether remifentanil-based anaesthesia is associated with clinically relevant acute opioid tolerance, expressed as greater postoperative pain scores or morphine consumption. Sixty patients undergoing elective gynaecological, non-laparoscopic, surgery were randomly assigned to receive remifentanil (group R, n=30) or sevoflurane (group S, n=30) based anaesthesia. Postoperative analgesia was provided with morphine through a patient-controlled infusion device. Mean (SD) remifentanil infusion rate in group R was 0.23 (0.10) µg kg–1 min–1 and mean inspired fraction of sevoflurane in group S was 1.75 (0.70)%. Mean (SD) cumulative morphine consumption during the first 24 postoperative hours was similar between groups: 28.0 (14.2) mg (group R) vs 28.6 (12.4) mg (group S). Pain scores, were also similar between groups during this period. These data do not support the development of acute opioid tolerance after remifentanil-based anaesthesia in this type of surgery.

Br J Anaesth 2001; 87: 866–9


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