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Remifentanil: an update

机译：瑞芬太尼：更新

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摘要

Remifentanil has now reached maturity, as reflected by the increasing number of clinical papers relating to its use. Its position among anaesthetic drugs is now better understood,and this review will attempt to place it in the context of current clinical practice.Propofol reduces the initial distribution of remifentanil, leading to higher concentrations during induction. Propofol and remifentanil administered together at sedative doses display a major synergistic interaction on the respiratory drive.Remifentanil accelerates the penetration of sevoflurane to its site of effect. The risk of intraoperative awareness seems to be low when remifentanil is associated to very low concentrations of hypnotic drugs, but this field warrants further investigation.Acute tolerance to opioids and its prevention remain controversial.Remifentanil is the opioid of choice for tracheal intubation without muscle relaxants. It provides an alternative to regional anaesthesia in labour pain control. Target-controlled infusion may further improve the administration of remifentanil.
机译：瑞芬太尼现已达到成熟，这反映在与其用途相关的临床论文数量上。现在人们已经更好地了解了其在麻醉药中的位置，并且本综述将尝试将其置于当前的临床实践中。异丙酚可降低瑞芬太尼的初始分布，从而导致诱导期间的浓度更高。镇静剂量的丙泊酚和瑞芬太尼合用对呼吸系统有重要的协同作用。瑞芬太尼可加快七氟醚向其作用部位的渗透。当瑞芬太尼与极低浓度的催眠药相关联时，术中知晓的风险似乎较低，但这一领域值得进一步研究。对阿片类药物的急性耐受性及其预防仍然存在争议。瑞芬太尼是无肌肉松弛剂的气管插管的首选阿片类药物。它为控制分娩痛提供了局部麻醉的替代方法。靶控输注可进一步改善瑞芬太尼的给药。

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