Remifentanil apnea: Case report and review of the literature

Related Experiment Video

Updated: May 27, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Nissar Shaikh1, Yolande Hanssens, André Louon

  • 1Department of Anesthesiology and Intensive Care, Hamad Medical Corporation-Hamad General Hospital, Doha, Qatar.

Journal of Anaesthesiology, Clinical Pharmacology
|November 19, 2011
PubMed

Insights

Excessive doses of remifentanil, an opioid analgesic, can cause dangerous side effects like apnea. Immediate ventilation is crucial for rapid recovery in intensive care patients.

Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Remifentanil is a potent opioid analgesic widely used in intensive care settings due to its rapid onset and short duration.
  • Its rapid peak serum levels can lead to severe, transient side effects if an excessive dose is administered.

Observation:

  • A case report details a 36-year-old woman who developed apnea, bradycardia, and hypotension.
  • These symptoms occurred after remifentanil infusion via a central venous catheter previously used for the drug.

Findings:

  • The patient experienced rapid onset of life-threatening side effects following remifentanil administration.
  • Immediate bag-valve-mask ventilation resulted in rapid improvement within 8 minutes.

Implications:

  • Highlights the critical need for vigilance regarding remifentanil dosage and administration routes in intensive care.
  • Emphasizes the importance of prompt recognition and immediate resuscitative measures for adverse events.
  • Informs acute care physicians, intensivists, anesthesiologists, and nurses about potential remifentanil-induced complications.
Keywords:
Apneabolus dosebradycardiahypotensionremifentanil

More Related Videos

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device09:36

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

Non-Intubated Video-Assisted Thoracoscopic Surgery05:39

Non-Intubated Video-Assisted Thoracoscopic Surgery

Published on: May 26, 2023

Related Concept Videos

Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
Respiratory Volumes and Capacities I01:26

Respiratory Volumes and Capacities I

Assessing the respiratory rate and rhythm for a complete minute is crucial for evaluating the breathing pattern. Even a minor increase in the patient's average respiratory rate, by as little as three to five breaths per minute, is an early and vital indicator of respiratory distress. Patients with a respiratory rate exceeding twenty-four breaths per minute require close monitoring to determine the physiological alterations. This careful observation is essential for prompt recognition and...