The clinical pharmacology of remifentanil: a brief review

Because it is still in its clinical infancy, it is difficult to predict with confidence exactly what role remifentanil will ultimately play in the delivery of anesthesia (and in other settings). It is clear, however, that remifentanil is a new pharmacologic tool with exciting potential that was not possible with the longer-acting opioids. On the basis of its familiar, fentanyl-like pharmacodynamic behavior and its short-acting pharmacokinetic profile, remifentanil may well be advantageous in a variety of settings in which profound opioid effect with subsequent rapid return of spontaneous ventilation and consciousness is desirable. Ongoing research and wide-spread clinical use will be required before the theoretical advantages associated with a short-acting opioid can be fully explored and confirmed.