Remifentanil is a synthetic opioid used in anesthesia and pain control for patients after surgery. This drug is very powerful and is administered by injection, usually in a clinical setting under the supervision of a physician. For patients who need pain control at home or in a hospice setting, other drugs are available. Like other opioids, remifentanil can be habit forming and people who need to use it for an extended period of time should use caution when they stop taking the drug.
This drug is a central nervous system depressant. Common side effects include slowed breathing and heart rate, nausea, and vomiting. In anesthesia and sedation, an anesthesiologist can administer this drug to manage pain and induce sedation, combining it with doses of other anesthetic medications to manage the patient's awareness level during the procedure. One advantage to this drug is its efficacy at inducing sedation in combination with other drugs, allowing doctors to use low doses of other medications when remifentanil is used.
For patients with severe pain after surgery, remifentanil can be administered for pain control. The patient can be transitioned to other medications, like fentanyl or morphine, as the recovery process proceeds. This medication is approximately twice as powerful as fentanyl. The remifentanil is offered by infusion and the delivery is carefully controlled to reduce the risks of an overdose.
This drug is rapidly metabolized and eliminated by the body. This means it does not build up, reducing the risk that a patient will develop opioid tolerance and need higher doses of these medications to manage pain effectively in the future. It also allows for very rapid recovery from anesthesia and sedation. Once the drug is withdrawn, the patient's body will eliminate the last remaining traces and the patient will become more alert and aware. Some patients feel some residual disorientation and itchiness immediately after surgery.
There is a risk of adverse reactions to remifentanil. Some patients are allergic to opioids or may be very sensitive and may experience allergic outbreaks like hives and anaphylactic shock. These risks are one reason the drug is usually administered in a clinical setting, where advanced life support systems are available to stabilize patients who react poorly to the drug. Breastfeeding mothers and pregnant women who need to take opioid drugs should discuss their conditions thoroughly with their physicians to carefully determine the best balance of medications for pain management without putting their babies or developing fetuses at risk.