Remifentanil Stats & Data

Standard anaesthetic practice uses continuous infusions of 0.05–0.25 µg kg⁻¹ min⁻¹; analgesia ceases within ~5 min of pump stoppage due to ester hydrolysis. Context-sensitive half-life is ~3–4 min regardless of infusion length. Bolus dosing outside monitored settings is strongly discouraged because apnoea or chest wall rigidity can occur before the syringe is empty. Chest/truncal rigidity with potent opioids is more likely with rapid IV pushes; slow administration and airway support are essential in clinical settings. Metabolism is by nonspecific blood/tissue esterases to an inactive acid; CYP inhibitors are not expected to prolong effect. Remifentanil can produce acute tolerance and opioid-induced hyperalgesia, especially after higher doses or abrupt cessation of infusions; expect rebound pain/craving within minutes once stopped. In overdose, prioritize airway/ventilation; give naloxone in small, titrated IV boluses (e.g., 0.04 mg) to restore breathing while minimizing severe withdrawal, and be prepared for re-sedation if longer-acting opioids or other depressants are present. Non-medical IV use carries high risks of hypoxia, infection, and BBVs; if people use regardless, sterile technique, low-dead-space syringes, never using alone, and access to naloxone/overdose response training reduce but do not eliminate risk.