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