Considerations for the use of short-acting opioids in general anesthesia.
Anesthesiologists play a critical role in facilitating a positive perioperative experience and early recovery for patients. Depending on the kind of procedure or surgery, a wide variety of agents and techniques are currently available to anesthesiologists to administer safe and efficacious anesthesia. Notably, the fast-track or ambulatory surgery environment requires the use of agents that enable rapid induction, maintenance, and emergence combined with minimal adverse effects. Short-acting opioids demonstrate a safe and rapid onset/offset of effect; that short effect is both predictable and precise. It also ensures easier titration and reduced or rapidly reversed side effects. Due to their distinct pharmacokinetic and pharmacodynamic properties, and, in one case, rapid extra-hepatic clearance of remifentanil, these agents have several applications in general anesthesia.
Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA. Electronic address: mandelj@uphs.upenn.edu.
Jeff E
JE
Mandel
D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D000776:Anesthesiology / Q000379:methods*; D018681:Anesthetics, General / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077208:Remifentanil; D013997:Time Factors
D000701:Analgesics, Opioid; D018681:Anesthetics, General; D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil
Alfentanil; General anesthesia; Propofol; Remifentanil; Short-acting opioids; Sufentanil; Total intravenous anesthesia