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Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52(07/08): 543-553
DOI: 10.1055/s-0042-122041
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Georg Thieme Verlag KG Stuttgart · New York

Remifentanil up2date – Teil 1

Remifentanil Up2date – Part 1
Stefan Bushuven
,
Sascha Kreuer
,
Peter Kranke
Further Information

Publication History

Publication Date:
25 July 2017 (online)

Also available at
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Zusammenfassung

Remifentanil ist ein kurzwirksames, potentes Opioid mit guter Steuerbarkeit – und vor allem in der ambulanten Anästhesiologie nahezu unverzichtbar. Umso härter trifft uns die seit 2016 eingeschränkte Verfügbarkeit und Kontingentierung. Dieser Beitrag liefert einen Überblick über die Substanz, ihre Geschichte und pharmakologischen Eigenschaften.

Abstract

Remifentanil is a short-acting opioid of high analgetic potency and superior controllability. It is widely used in day-case surgery, procedural sedation, for reduction of recovery-times and obstetrics and whenever excellent controllability of opioid effects is needed. Especially in combination with Propofol it is used for target-controlled infusion (TCI). The first part of the article provides readers with information about historical aspects, pharmacological characteristics, effects and side effects of remifentanil.

Kernaussagen

  • Remifentanil ist mittlerweile seit 20 Jahren im klinischen Einsatz.

  • Die Substanz zeigt aufgrund ihrer starken Aktivierung von MOR-1 und MOR-2 alle bekannten Opioideffekte und entsprechende unerwünschte Wirkungen.

  • Vor allem die Thoraxrigidität sowie die vagale Stimulation sind im Gegensatz zu anderen Opioiden von anästhesiologischer Relevanz. Da sich diese vor allem bei Bolusgabe zeigen, sollte diese mit Vorsicht eingesetzt werden.

  • Bei Patienten mit Erkrankungen des kardialen Reizleitungssystems sollte Remifentanil ebenfalls sehr vorsichtig eingesetzt werden.

  • Pharmazeutisch ist weiterhin die Lagerung des rekonstituierten Konzentrats sowie der Verdünnungslösungen von Interesse.

  • Ökologisch spielt die Substanz anscheinend eine untergeordnete Rolle.

Schlüsselwörter

Remifentanil - Pharmakologie - unerwünschte Wirkungen - Lagerung

Key words

Remifentanil - pharmacology - side effects - storage
 

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