title: [Remifentanil and its future: preface and comments].
abstract: Remifentanil is bound strongly to the mu-opioid receptor and less to the delta - and kappa -receptors. It has pharmacodynamic properties like those of fentanyl and its derivatives. Remifentanil is not bound significantly to any other non-opioid receptors and is competitively antagonized by naloxone. Metabolism by nonspecific esterases gives remifentanil a pharmacokinetic profile unlike that of any other opioid. The clinical advantage of the drug lies in its extremely rapid clearance, and therefore offset of its effect is independent of excretory organ function. We have waited over the 35 years to have the new opioid, remifentanil available for clinical anesthesia in Japan, since the last opioid, fentanyl was introduced in our country. This drug is ultra-super short acting and shows almost no accumulation in the body. These characteristics must be very convenient for the anesthesia technique of ambulatory surgery. However, on the opposite side, we should consider the management of postoperative pain for the patient after the remifentanil anesthesia. These topics on the characteristics of remifentanil and its future are discussed by the experts among Japanese anesthesiologists.
authors.affiliation: JR Tokyo General Hospital, Tokyo 151-8528.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hanaoka
mesh_terms: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D006801:Humans; D010880:Piperidines; D000077208:Remifentanil
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil