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Review of the efficacy and safety of remifentanil for the prevention and treatment of pain during and after procedures and surgery

Authors Sivak E, Davis P

Published 15 July 2010 Volume 2010:3 Pages 35—43

DOI https://doi.org/10.2147/LRA.S7709

Review by Single anonymous peer review

Peer reviewer comments 2


Erica L Sivak, Peter J Davis

Department of Anesthesiology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

Abstract: Remifentanil is an ultrashort-acting synthetic opioid. It is metabolized by ­nonspecific tissue and plasma esterases. Remifentanil’s metabolism is responsible for its unique pharmacokinetic profile and flat, context-sensitive half-time. Since its introduction into clinical practice, remifentanil has been used for a variety of anesthetic and analgesic applications; however, concerns regarding a potential for rapid induction of tolerance and/or induced hyperalgesia, coupled with an ultrarapid offset of effect, make the drug less than optimal for use in the pharmacologic management of pain.

Keywords: regional anesthesia, intravenous anesthesia, tolerance, hyperalgesia, rapid offset

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