Active Ingredients

Remifentanil – Effect, Application & Risks


Remifentanil is a highly effective opioid, which is used in particular in the context of anesthesia . The anesthetic or sedative has an effect that is around 200 times stronger than that of morphine.

What is remifentanil?

Remifentanil belongs to the group of active ingredients that are often used if the proven morphine does not have a sufficient effect in the course of pain treatment or as an anesthetic .

The opium is used both as a sedative and in the course of anesthesia, which results, among other things, from the excellent controllability of the active substance. In practice, the remedy is therefore often used in the context of operations. One of the essential properties of the drug is that it contains glycine. Therefore, the drug must not be used in the course of spinal anesthesia.

Remifentanil is not only used in the context of anesthesia, but is also often used in practice for sedation. The drug is also more commonly used for respiratory depression. Since the active substance is broken down independently of the organs, it is not necessary to adjust the dosage of remifentanil in the case of impaired liver or kidney function.

Pharmacological action

The effect of remifentanil is primarily characterized by the fact that the drug has both an analgesic and a strong calming (sedating) effect.

As a so-called selective µ-opioid agonist, the main effect is that it occurs very quickly and is easy to calculate. Normally, the desired effect occurs just one minute after administration of the drug. It is also characteristic of the effect that it is only short-lived. The half-life is usually given as being between two and ten minutes.

For this reason, it is important, for example in the course of anesthesia, that the active substance is continuously supplied. The effect on the organism can be reversed by so-called opioid antagonists, such as naloxone.

Due to the effect described, remifentanil is often referred to as a “soft drug”. With regard to the effect, it is important to note that the dosage of remifentanil must be adapted to the respective age of the patient.

Medical Application & Use

The opioid remifentanil is used in practice in a number of ways. It is most commonly used during anesthesia administered in connection with surgical procedures. In this context, the active ingredient is primarily used in total intravenous anesthesia.

A combination with propofol then usually takes place . In addition, remifentanil is also used if analgesia is to be continued in the course of a direct postoperative period. In any case, remifentanil is often used for analgesia and sedation in intensive care. Because of the relatively short half-life already mentioned, the opioid is usually administered via a so-called syringe pump.

Due to the short duration of action, one advantage is that there is normally no overhang of the effect. Especially because of this very good controllability, remifentanil is very common nowadays, especially in the field of outpatient anesthesia and is used frequently. But Remifentanil can also be used for less painful measures, such as lithotripsy (treatment of bladder and kidney stones ).

Risks & side effects

Since remifentanil is an effective and targeted agent, side effects can occur in some cases after administration.

First and foremost, these are side effects that are generally very typical of opioids. It should be noted that thoracic rigidity can be more pronounced, especially compared to many other opioids. Basically, for example , respiratory depression , dizziness , nausea , vomiting and constipation are among the typical side effects that can occur after the administration of remifentanil.

Other possible side effects of remifentanil also include hypotension or muscle rigidity. The doctor treating you can provide information on all possible side effects.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.