Opioid use in treated and untreated obstructive sleep apnoea: remifentanil pharmacokinetics and pharmacodynamics in adult volunteers
Authors' conclusion
OSA (untreated or treated) did not influence remifentanil pharmacokinetics or pharmacodynamics (miosis, analgesia, respiratory depression).
Study context
- Population
- Awake adult volunteers (median age 52 yr, range 23–70) with or without obstructive sleep apnoea (OSA)
- Participants
- 20 / 33 / 21
- Exposure
- Untreated OSA vs treated OSA vs no OSA
- No OSAn = 20reference
- Untreated OSAn = 33
- Treated OSAn = 21
- Outcome
- Remifentanil PK (clearance, volume of distribution) and PD (miosis, thermal heat tolerance, end-expired CO2)
Methodological detailspharmacokinetic/pharmacodynamic, single-centre, open-label, stepped-dose TCI remifentanil infusion, population PK/PD modelling
- Pharmacokinetic/pharmacodynamic
- Single-centre
- Open-label
- Stepped-dose TCI remifentanil infusion
- Population PK/PD modelling
Main finding
As reported in the abstract
Remifentanil PK
| Group | Value | Volume of distribution |
|---|---|---|
| No OSA | median 147 L h-1 | 19.6 L |
| Untreated OSA | median 143 L h-1 | 15.5 L |
| Treated OSA | median 155 L h-1 | 17.7 L |
Value
No OSAmedian 147 L h-1
Untreated OSAmedian 143 L h-1
Treated OSAmedian 155 L h-1
Volume of distribution
No OSA19.6 L
Untreated OSA15.5 L
Treated OSA17.7 L
- No OSA: P = 0.472
- No OSA: P = 0.473
Observational data: associations, not effects.
Further findings
Model-estimated pupil area (% of baseline) at plasma remifentanil 4 ng ml-1 · across 3 groups
P = 0.086
Model-estimated thermal heat tolerance at plasma remifentanil 4 ng ml-1 · across 3 groups
P = 0.218
Model-estimated end-expired CO2 at plasma remifentanil 4 ng ml-1 · across 3 groups
P = 0.257
Original publication
Opioid use in treated and untreated obstructive sleep apnoea: remifentanil pharmacokinetics and pharmacodynamics in adult volunteers. Br J Anaesth. Published 20 January 2025. doi:10.
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