Remifentanil Flashcards
What is Remifentanil and its significance in anesthesia?
Remifentanil is a potent, ultra-short-acting synthetic opioid analgesic, known for its rapid onset and offset, predictable pharmacokinetics, and excellent analgesic properties, making it valuable for procedures requiring precise control of analgesia.
Describe the onset and offset characteristics of Remifentanil.
It has an extremely rapid onset (1-2 minutes) and short duration of action due to metabolism by plasma esterases, allowing for quick adjustments in anesthetic depth and recovery.
How do Remifentanil’s pharmacokinetics benefit patient management?
Its pharmacokinetics are relatively unaffected by factors like age, weight, renal or hepatic function, enabling more effective titration for individual patients.
Explain the analgesic properties of Remifentanil.
Remifentanil provides effective analgesia for various surgical procedures, reducing the need for additional medications and improving patient comfort.
What makes Remifentanil suitable for fast-track anesthesia?
Due to its rapid elimination, patients often recover quicker from anesthesia, facilitating early mobilization and shortening hospital stays.
Discuss Remifentanil’s utility in monitored anesthesia care.
It is used for sedation and analgesia in MAC, allowing patients to maintain spontaneous ventilation while receiving appropriate sedation levels.
Detail Remifentanil’s mechanism of action.
Remifentanil acts on mu-opioid receptors, inhibiting adenylate cyclase and modulating ion channels, leading to the inhibition of pain transmission in the CNS and providing analgesia and sedation.
What are the key pharmacological effects of Remifentanil?
A selective Mu-1 and Mu-2 agonist, 75-100 times more potent than morphine, with a unique ester linkage that allows for rapid hydrolysis to inactive metabolites by plasma and tissue esterases.
How does Remifentanil’s metabolism differ from other opioids?
Its ester linkage makes it susceptible to hydrolysis by nonspecific plasma and tissue esterases, leading to a small volume of distribution, rapid clearance, and independence from renal or hepatic function.
What are the potential side effects of Remifentanil?
Acute opioid tolerance and hyperalgesia may occur, especially after exposure to high doses.
Discuss the context-sensitive half-time of Remifentanil.
Remifentanil’s context-sensitive half-time is around 4 minutes, independent of the duration of infusion, making it ideal for procedures where rapid recovery is desirable.
