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Spotlight on remifentanil for general anaesthesia
Lesley J Scott1, Caroline M Perry
1Adis International Limited, Auckland, New Zealand. demail@adis.co.nz
CNS Drugs
|December 8, 2005
Summary
Remifentanil (Ultiva) is an ultra-short acting opioid analgesic effective for various surgeries. Its unique pharmacokinetic profile ensures rapid offset and predictable recovery, making it a valuable option for general anesthesia.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Remifentanil is a fentanyl derivative and a selective mu-opioid receptor agonist.
- It is metabolized by non-specific esterases, resulting in a unique pharmacokinetic profile.
Purpose of the Study:
- To evaluate the efficacy and tolerability of remifentanil as an adjunctive analgesic during general anesthesia.
- To compare remifentanil-based regimens with fentanyl- or alfentanil-based regimens.
Main Methods:
- Adjunctive intravenous remifentanil was administered during general anesthesia for various surgical procedures.
- Patient populations included adults and pediatric patients in inpatient and outpatient settings.
- Remifentanil was used in combination with intravenous or volatile hypnotic agents.
Main Results:
- Remifentanil demonstrated efficacy and was generally well-tolerated across a broad spectrum of patients and procedures.
- Remifentanil-containing regimens were comparable in effectiveness to fentanyl- or alfentanil-containing regimens.
- Key parameters included attenuation of intraoperative responses and postoperative recovery.
Conclusions:
- Remifentanil offers rapid offset of action and a short context-sensitive half-time, regardless of infusion duration.
- It is a valuable opioid analgesic for balanced general inhalational or total intravenous anesthesia.
- The drug facilitates rapid, titratable analgesia with fast and predictable recovery.