Remifentanyl w intensywnej terapii

Paweł Ratajczyk, Tomasz Gaszyński, Wojciech Gaszyński

Summary
The majority of patients in the ICU require sedation to reduce anxiety, minimize stress and to increase tolerance to mechanical ventilation. Since no universal solution of this problem exists, various sedatives, analgesics and their combinations have been used for sedation. In most recent studies, the uses of remifentanil, dexmetomidine and new volatile agents were reported. The rapid onset and offset of action of remifentanil make it quickly adjustable to the required level of sedation, allow a more rapid emergence from sedation and facilitate earlier extubation. Remifentanil does not exert prolonged clinical effects in renal and liver failure patients. Its short and predictable time of action makes it also suitable for neurosurgical patients. Remifentanil may be also suitable for sedation of the COPD and morbidly obese patients. It also provides an excellent pain control in the postoperative and in the ICU settings.

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