Pharmacodynamics and pharmacokinetics of remifentanil: Overview and comparison with other opioids

In this review, the authors tried to summarize the characteristics and main differences of remifentanil with other opioids, and to overview its pharmacodynamics and pharmacokinetics. Clearance and volume of distribution of remifentnail are extremely different from other conventional opioids. In addition, the context-sensitive half time of remifentanil is almost stable (about 3 minutes) even if the continuous infusion of remifentanil lasts for longer than 10 hours. As remifentanil is metabolized by a non-specific esterase, excretion of remifentnil is predictable in basically all patients undergoing general anesthesia and surgery. Therefore, remifentanil is considered to be an optimal opioid as an analgesic combined either with inhalational anesthetics or intravenous hypnotics in balanced general anesthesia.