Remifentanil: Por Que Precisamos de Outro Opióide?
Remifentanil: Do We Need Any Other Opioid?
Fernando Squeff Nora, Elaine Aparecida Felix Fortis
Resumo
Justificativa e Objetivos - O remifentanil é o mais recente opióide em uso clínico. Apresenta rápido início de ação e depuração, sendo metabolizado por esterases plasmáticas e teciduais inespecíficas. O objetivo desta revisão é apresentar as características farmacocinéticas e famarcodinâmicas do remifentanil, e seu emprego clínico em diversas cirurgias. Conteúdo - São apresentadas as características farmacocinéticas e famarcodinâmicas do remifentanil, comparando-as com a de outros opióides. São comentados resultados de trabalhos em cirurgias abdominais, torácicas, ortopédicas e cardíacas. Conclusões - O remifentanil tem perfil adequado para cirurgias de curta duração, em regime de infusão contínua em anestesia venosa ou ainda, como analgésico, em anestesias balanceadas em que se necessita de proteção aos estímulos nociceptivos e despertar precoce.
Palavras-chave
Abstract
Background and Objectives - Remifentanil is the newest opioid for clinical use. It has a fast onset and clearance times, being metabolized by nonspecific tissue and plasma esterases. This study aimed at presenting pharmacokinetic and pharmacodynamic characteristics of remifentanil and its clinical use in different surgeries. Contents - Pharmacokinetic and pharmacodynamic characteristics of remifentanil are presented and compared to other opioids. Results of abdominal, thoracic, orthopedic and cardiac surgeries are commented. Conclusions - Remifentanil is adequate for short surgeries in intravenous continuous infusion anesthesia or even providing analgesia in balanced anesthesias, when you look for noxious stimuli protection and early emergence.
Keywords
Referências
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