Remifentanil

Question 1

What is remifentanil?

Answer 1

Synthetic opioid. White crystalline powder. 1/2/5mg per vial. Reconstitute with 0.9% saline. Give as IV infusion.

Question 2

What is the dose of remifentanil?

Answer 2

0.05 - 2 mcg/kg/min

Question 3

What is the metabolism and excretion of remifentanil?

Answer 3

• undergoes rapid ester hydrolysis by non-specific plasma/tissue esterases to carboxylic acid derivitives
• these are saturated by infusion
• excreted in urine

Question 4

What is the absorption/distribution of remifentanil?

Answer 4

• only given IV
• half life 2hrs
• effects last only 10mins from termination of infusion
• context insensitive half life

Question 5

What are the uses of remifentanil?

Answer 5

• analgesia during GA
• hypotensive anaesthesia
• sedation on ICU and for awake procedures eg fibreoptic intubation

Question 6

What is the MOA of remifentanil?

Answer 6

Pure MOP opioid receptor agonist

Question 7

What are the SEs of remifentanil?

Answer 7

• As for morphine but
  
  • 50-80x as potent
    
    • bradycardia = may be profound, esp if bolused

Question 8

What are the chemical properties of remifentanil?

Answer 8

Because of rapid hydrolysis, effect of infusion is gone within 10mins of discontinuation. No residual analgesia.