Remifentanil as an anesthetic agent in children

They also promotehaemodynamicstability, minimalrespiratorydepression, witha rapidrecoveryprofile. Theuseof remifentanil in neonates and young infants is increasing despite the difficulties in obtaining high standard objective evidence in this age group. Remifentanil’s pharmacokinetic and pharmacodynamic profile in this age group is similar to that of older children, which may have several theoretical advantages.

Reports of a rapid development of μ-receptor tolerance with remifentanil are in conflict; activity at δ-opioid receptors may contribute. Remifentanil produce a fall in blood pressure and cardiac index, mainly as a result of a fall in heart rate. Although atropine is able to reduce the fall in heart rate, is not able to prevent completely the reduction in cardiac index.

Remifentanil has been described as a titratable opioid. It has been reported to be ideally suited to the sedation of selected neurosurgical patients who require frequent neurological examinations. It may also provide suitable analgesia based sedation in mechanically ventilated children postoperatively.