The Use of Remifentanil in Clinical Anaesthesia
Maged Saad Abd El-Messih;
Abstract
Opioids have been used in the treatment of pain for thousands of years. The drug "opium" is obtained from the exudate of seed pods of the poppy papaver somniferum and the word "opium" is derived from "opos';:the Greek
word for juice. The first undisputed reference to poppy juice is found in the third
century B.C. writings ofTheophrastus.
Opioid receptors and endogenous opioid peptides appear very early in CNS development and their ontogeny is non-uniform in the neonatal rat. The majority of receptors in the adult are mu () and delta (o), but early in the postnatal period, on postnatal day 6 (P6), mu (Jl) and kappa (K) receptors predominate.
There are three opioid receptor types, which are named according to the prototype agonist producing the distinct physiological effect, niu (Jl) for morphine, kappa (K) for ketocyclazocine and delta (o). The sigma (cr) receptor is
not an opioid receptor, as actions mediated by it is not reversed by naloxone.
The increasing use of out patient surgery as a standard of practice and a cost containment measure has created a demand for shorter acting agents for use in anaesthesia.
The newest opioid approved for clinical use in anaesthesia is remifentanil, a new opioid chemically related to fentanyl and its congeners. Its distinguishing feature is a propanoic methyl ester which is susceptible to rapid hydrolysis by non-specific esterases in blood and peripheral tissues. Remifentanil is a typical opioid agonist which is highly selective for receptors. Remifentanil inherits, the good (e.g. analgesia), the bad (e.g., ventilatory depression) and the ugly (e.g. muscle rigidity) characteristics of its family of mu () receptor agoinst, also
word for juice. The first undisputed reference to poppy juice is found in the third
century B.C. writings ofTheophrastus.
Opioid receptors and endogenous opioid peptides appear very early in CNS development and their ontogeny is non-uniform in the neonatal rat. The majority of receptors in the adult are mu () and delta (o), but early in the postnatal period, on postnatal day 6 (P6), mu (Jl) and kappa (K) receptors predominate.
There are three opioid receptor types, which are named according to the prototype agonist producing the distinct physiological effect, niu (Jl) for morphine, kappa (K) for ketocyclazocine and delta (o). The sigma (cr) receptor is
not an opioid receptor, as actions mediated by it is not reversed by naloxone.
The increasing use of out patient surgery as a standard of practice and a cost containment measure has created a demand for shorter acting agents for use in anaesthesia.
The newest opioid approved for clinical use in anaesthesia is remifentanil, a new opioid chemically related to fentanyl and its congeners. Its distinguishing feature is a propanoic methyl ester which is susceptible to rapid hydrolysis by non-specific esterases in blood and peripheral tissues. Remifentanil is a typical opioid agonist which is highly selective for receptors. Remifentanil inherits, the good (e.g. analgesia), the bad (e.g., ventilatory depression) and the ugly (e.g. muscle rigidity) characteristics of its family of mu () receptor agoinst, also
Other data
| Title | The Use of Remifentanil in Clinical Anaesthesia | Other Titles | استخدام عقار الريميفنتانيل فى التخدير الطبى | Authors | Maged Saad Abd El-Messih | Issue Date | 2000 |
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