Remifentanil-Induced Respiratory Failure in PACU after a Brainstem Tumor Debulking: Acute Diagnostic Dilemma-Juniper Publishers
Juniper Publishers - Journal of Anesthesia Abstract A 66 year old man developed sudden apnea and unresponsiveness after a large cerebellopontine angle tumor debulking. Based on the findings of a focused neurologic exam, the patient was emergently mask ventilated with subsequent return of spontaneous ventilation minutes later and recovery without further complications. Remifentanil bolus from residual infusion in an IV line was suspected due to rapid return to baseline and acute neurologic findings. We review remifentanil and highlight a challenging diagnostic dilemma in an acutely apneic patient after major neurosurgery. Keywords: Remifentanil; Neuroanesthesia; Post-op respiratory failure; Neurologic Emergencies Key Messages a. A focused neurologic exam can affect emergent management. b. A high index of suspicion and staff education are necessary for those involved in the care of patients receiving remifentanil. Int...