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Remifentanil

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Summary

▴ Remifentanil is a new selective μ opioid receptor agonist of higher potency than alfentanil, with pharmacological effects that essentially parallel those of alfentanil and other opioids in this class.

▴ Unlike other opioids, remifentanil is rapidly hydrolysed by nonspecific plasma and tissue esterases: this imparts brevity of action, precise and rapidly titratable effects (due to rapid onset and offset), non-cumulative opioid effects and rapid recovery after cessation of administration.

▴ The onset of action of remifentanil is similar to that of alfentanil, although its offset is considerably more rapid and independent of the duration of infusion. Remifentanil also has a sparing effect on hypnotics and sedatives.

▴ Its brevity of action ensures not only a rapid resolution of adverse effects but also a rapid offset of analgesic effect. Therefore, appropriate postoperative analgesia, when necessary, should be established before discontinuation of remifentanil infusion.

▴ The unique pharmacokinetic profile of remifentanil facilitates ‘real time’ management of intraoperative stress, as well as provision of optimal intraoperative analgesia without compromising recovery for a variety of surgical procedures.

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Authors and Affiliations

  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland 10, New Zealand

    Sanjay S. Patel & Caroline M. Spencer

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  1. Sanjay S. Patel
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  2. Caroline M. Spencer
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Patel, S.S., Spencer, C.M. Remifentanil. Drugs 52, 417–427 (1996). https://doi.org/10.2165/00003495-199652030-00009

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  • DOI: https://doi.org/10.2165/00003495-199652030-00009

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