レミフェンタニル

使用用途

• Analgesic adjunct to general anesthesia
• Analgesic adjunct to general anesthesia
• Analgesic adjunct to general anesthesia

投与方法

考えられる副作用

• Respiratory depression
• Apnea
• Bradyarrhythmias
• Hypotension
• Hyperthermia (noted in cats)
• Anaphylaxis (rare)

注意事項と禁忌

• Hypersensitivity to remifentanil or other fentanyl analogs
• Epidural or intrathecal administration (contraindicated due to the presence of glycine in the formulation)
• Because of the high risk of significant **respiratory depression** (including apnea) and **bradycardia**, remifentanil must ONLY be administered in a closely monitored anesthesia care setting with intubation and mechanical ventilation capabilities. * **Administration**: Continuous infusions should strictly be administered via a calibrated syringe pump or infusion device. * **Obesity**: In morbidly obese patients, the dosage should be calculated based on ideal body weight rather than actual body weight. * **Pregnancy**: Weigh potential risks versus benefits. FDA Category C for humans. No teratogenic effects observed in limited animal studies, but fetal respiratory depression is possible.

薬物相互作用

• CNS Depressants (e.g., propofol, isoflurane, thiopental): Additive CNS and respiratory depression; remifentanil significantly reduces MAC and induction agent requirements.
• Diuretics: Opiates may decrease diuretic efficacy in patients with congestive heart failure.
• Monoamine Oxidase Inhibitors (e.g., amitraz, selegiline): Severe and unpredictable opiate potentiation may occur; use is generally not recommended if an MAOI has been used within 14 days.
• Skeletal Muscle Relaxants: Remifentanil may enhance neuromuscular blockade.
• Nitrous Oxide: High doses of remifentanil combined with nitrous oxide may cause cardiovascular depression.
• Tricyclic Antidepressants (e.g., clomipramine, amitriptyline): May exacerbate the effects of tricyclic antidepressants.
• Warfarin: Opiates may potentiate anticoagulant activity.

よくある質問