Review of the efficacy and safety of remifentanil for the prevention and treatment of pain during and after procedures and surgery

Abstract

Remifentanil is an ultrashort-acting synthetic opioid. It is metabolized by nonspecific tissue and plasma esterases. Remifentanil’s metabolism is responsible for its unique pharma- cokinetic profile and flat, context-sensitive half-time. Since its introduction into clinical practice, remifentanil has been used for a variety of anesthetic and analgesic applications; however, concerns regarding a potential for rapid induction of tolerance and/or induced hyperalgesia, coupled with an ultrarapid offset of effect, make the drug less than optimal for use in the phar- macologic management of pain. Keywords: