[Remifentanil. An update].
Remifentanil is a 4-anilidopiperidine mu-opioid analgesic which is rapidly metabolized by unspecific blood and tissue esterases. According to its unique pharmacokinetic profile, remifentanil-based anaesthesia combines high-dosage opioid analgesia intraoperatively with a rapid and predictable postoperative awakening. When compared with a standard fentanyl-based technique, the use of remifentanil has changed our present anaesthetic regimens. This includes the anaesthesia induction sequence, the choice and dosage of anaesthetics when used as adjuncts to remifentanil, and even more, the proper planning of postoperative pain management. The present paper was designed to review the current knowledge on remifentanil and all aspects of its use in anaesthesiology. In addition, present data on the use of remifentanil for analgesia and sedation of the critically ill patient are summarized.
Wilhelm
W
W
Klinik für Anaesthesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Homburg/Saar. wolfram.wilhelm@uniklinik-saarland.de
Wrobel
M
M
Kreuer
S
S
Larsen
R
R
D000375:Aging / Q000378:metabolism; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000493:pharmacokinetics; D000818:Animals; D000075202:Contraindications; D003422:Critical Care; D006801:Humans; D007674:Kidney Diseases / Q000378:metabolism; D008107:Liver Diseases / Q000378:metabolism; D010149:Postoperative Pain / Q000188:drug therapy; D010880:Piperidines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077208:Remifentanil
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil