Remifentanil well suited to intraoperative analgesia

Remifentanil is a new opioid which combines ultra-short action with potent analgesic properties. Moreover, remifentanil has a fast onset of action because of rapid blood-brain equilibration. This rapid onset and offset of action provides several advantages including precise and rapidly titratable effects, non-cumulative opioid activity and rapid recovery after cessation of administration. However, clinicians need to be aware of the wider implications of these features of remifentanil. Rapid onset of opioid effect tends to be associated with a higher incidence of muscle rigidity. Furthermore, the rapid decline in remifentanil concentration parallels the rapid return of pain, and therefore postoperative analgesia must be adequately planned.