Remifentanil B. Braun

Remifentanil HCl

Analgesic agent for use during induction &/or maintenance of general anaesth. For provision of analgesia in mechanically ventilated intensive care patients ≥18 yr.

General anaesth Individualised based on patient's response. Adult Manually Controlled Infusion (MCI) Induction of anaesth: Infusion rate of 0.5-1 mcg/kg/min, w/ or w/o bolus inj of 1 mcg/kg given over not <30 sec. Maintenance of anaesth in ventilated patients: 0.5-1 mcg/kg bolus inj; infusion starting rate w/ nitrous oxide: 0.4 mcg/kg/min (range: 0.1-2); w/ isoflurane: 0.25 mcg/kg/min (range: 0.05-2); w/ Propofol: 0.25 mcg/kg/min (range: 0.05-2). Supplemental analgesia in spontaneously breathing anaesthetized patients: Starting infusion rate of 0.04 mcg/kg/min. Target-Controlled Infusion (TCI) Induction of anaesth & surgery: 3-8 ng/mL target blood remifentanil conc, titrated to individual patient response. Stimulating surgical procedures: Up to 15 ng/mL target blood remifentanil conc. ASA III/IV patients: 1.5-4 ng/mL, titrated to response. Childn 1-12 yr Maintenance of anaesth: 1 mcg/kg bolus inj; continuous infusion starting rate: 0.25 mcg/kg/min; maintenance rate w/ halothane: 0.05-1.3 mcg/kg/min; w/ sevoflurane: 0.05-0.9 mcg/kg/min; w/ isoflurane: 0.06-0.9 mcg/kg/min. Cardiac anaesth MCI Intubation: Continuous infusion rate of 1 mcg/kg/min. Maintenance of anaesth: 0.5-1 mcg/kg bolus inj. Starting infusion rate of 1 mcg/kg/min; typical infusion rates: 0.003-4 mcg/kg/min (w/ isoflurane); 0.01-4.3 mcg/kg/min (w/ Propofol). Continuation of post-op analgesia, prior to extubation: Starting infusion rate of 1 mcg/kg/min; typical infusion rates 0-1 mcg/kg/min. Use in intensive care Adult Continuous infusion starting rate: 0.1-0.15 mcg/kg/min. Range: 0.006-0.74 mcg/kg/min.

Hypersensitivity to remifentanil & other fentanyl analogues. For use as the sole agent for induction of anaesth. Epidural & intrathecal use.

Rapid offset of action. W/drawal symptoms including tachycardia, HTN & agitation. Use of remifentanil in mechanically ventilated intensive care patients for >3 days is not recommended. Muscle rigidity; resp depression; hypotension & bradycardia. May produce dependency. Severe hepatic impairment. Obese patients. ASA III/IV patients. Major influence on the ability to drive & use machines. Pregnancy & lactation. Neonates/infants <1 yr. Elderly >65 yr.

Skeletal muscle rigidity; hypotension; nausea, vomiting. Bradycardia; post-op occurring HTN; acute resp depression, apnoea; pruritus; post-op shivering.

Decreased dose requirement for anaesth of inhalational & IV anaesthetics, & benzodiazepines. Exacerbated CV effects w/ cardiac depressant drugs eg, β-blockers & Ca channel blocking agents.

Anaesthetics - Local & General

N01AH06 - remifentanil ; Belongs to the class of opioid anesthetics. Used as general anesthetics.

DD, P₁S₁S₃