Remifentanil in children

Paediatric Anaesthesia
Maria SammartinoNicola Continolo

Abstract

Remifentanil has gained the confidence of anesthesiologists and has given a real opportunity to change the way anesthesia is given. It can be considered the ideal opioid despite many obstacles to pediatric use: the condition of 'off-label', the lack of wide randomized clinical trials, and the fear of adverse events because of its high potency. Experiences in the field with this opioid over the years encouraged its use. Use has been associated with N(2)0 and volatile agents for general anesthesia and with propofol for total intravenous anesthesia (TIVA). It seems very useful for sedation inside and outside the operating room and in intensive care for both short painful procedures and synchronization with mechanical ventilation. However, its unique pharmacokinetic characteristics causing rapid onset and offset of effect appear unchanged in small children and even in premature neonates and need to be really confirmed by further pharmacokinetic studies. Moreover, the real risks of tolerance and hyperalgesia should be evaluated in the pediatric population. In this review, we go through the newer aspects of this versatile drug that has been proposed as 'the pediatric anesthetist's opiate'.

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Citations

Jul 18, 2012·Pediatric Reports·Francesco DonesVincenzo Russotto
Aug 14, 2010·International Journal of Pediatrics·Todd J KilbaughJimmy W Huh
Jun 28, 2011·Pediatrics and Neonatology·Maria SammartinoPatrizia Papacci
Mar 16, 2011·Paediatric Anaesthesia·Grace L S Wong, Neil S Morton
May 18, 2010·Paediatric Anaesthesia·Keira P Mason
Nov 23, 2011·Anesthesia and Analgesia·Daphne MicheletSouhayl Dahmani
Jun 20, 2018·European Journal of Drug Metabolism and Pharmacokinetics·Jing ChangMa-Zhong Zhang
Nov 28, 2017·Clinical Pharmacokinetics·Victoria C ZiesenitzJohannes N van den Anker
Jan 25, 2011·Expert Opinion on Pharmacotherapy·Wai Yin MakTheresa Hui
Dec 8, 2011·International Journal of Immunopathology and Pharmacology·F FranceschiniR Bernardini
Jul 9, 2017·Clinical Pharmacokinetics·Victoria C ZiesenitzJohannes N van den Anker

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