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Remifentanil: when and how to use it

F Servin1

  • 1Département d'anesthésia, Hôpital Bichat, Paris, France.

European Journal of Anaesthesiology. Supplement
|May 1, 1997
PubMed

Insights

Remifentanil, a potent opioid, offers rapid metabolism and predictable effects, unaffected by organ dysfunction. Its unique profile necessitates changes in postoperative pain management strategies for enhanced patient safety.

Area of Science:

  • Anesthesiology and Pharmacology

Background:

  • Remifentanil is a potent mu-opioid agonist with rapid metabolism by tissue esterases.
  • This unique pharmacokinetic profile is independent of renal or hepatic function.

Purpose of the Study:

  • To evaluate the implications of remifentanil's pharmacokinetic profile on its use in general anesthesia and cardiac surgery.
  • To discuss modifications needed for postoperative pain control and sedation.

Main Methods:

  • Pharmacokinetic analysis of remifentanil metabolism.
  • Review of clinical applications in general anesthesia and cardiac surgery.
  • Assessment of impact on emergence times and postoperative pain management.

Main Results:

  • Remifentanil pharmacokinetics are unaffected by severe renal or hepatic dysfunction.
  • Dosage adjustments are not required during general anesthesia, with no undue lengthening of emergence times.
  • Rapid offset of action requires revised approaches to early postoperative pain control.

Conclusions:

  • Remifentanil can be used safely in various surgical settings, including cardiac surgery, due to predictable pharmacokinetics.
  • Its use as a sedative or postoperative analgesic requires careful administration, avoiding bolus doses.
  • Implementation of remifentanil necessitates significant changes in prescribing habits to maximize patient safety and optimize outcomes.

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