Pharmacokinetics and pharmacodynamics of remifentanil: A review

Abstract

Remifentanil is an opioid anesthetic that has today become one of the most popular drugs used in modern anesthetic practice. For this reason, its distinct pharmacokinetic and pharmacodynamic profile renders it a useful agent for intraoperative pain management and co-induction of anesthesia. Ramifentanil possesses rapid onset and offset, short duration of action, and experiences minimum tissue accumulation. The above properties are attributed to high lipophilicity, fast distribution, and metabolism by plasma esterase enzymes. Remifentanil is an active metabolite of heterocyclic ethyl carbamate, having actions that reflect potent opioid agonist effects manifested by analgesia, sedation, and respiratory depression. It involves a low propensity to cause histamine release and relatively few cardiovascular side effects; hence, i t is recommended for use by those with allergic reactions or cardiovascular disorders. Remifentanil is an ultra-short-acting, highly potent anesthetic mostly used as an opioid anesthetic agent possessing distinguishable characteristics in pharmacokinetics and pharmacodynamics. Nonetheless, it exerts significant toxicology with specific reference to respiratory depression, thus requiring thorough management. When ramifentanil pharmacokinetics and pharmacodynamics are well known, one can eliminate unfavorable consequences and use the drug most efficiently. Remifentanil is very short-acting due to its rapid metabolism by esterase in the blood. This rate of metabolism makes them capable of rapid induction and recovery, which makes them suitable for use in procedures that require a fast start and finish.