Continuous remifentanil for pediatric neurosurgery patients

Objective: Remifentanil hydrochloride is a new titratable opioid agonist with rapid onset and offset of action. We present 2 cases of intracranial mass lesions in whom remifentanil was used to obtain serial neurological examinations. Methods: Patients received bolus doses of remifentanil 1 µg/kg followed by continuous infusions of 0.1–0.5 µg/kg/min, titrated to effect. After the clinical examination, the remifentanil was restarted to the desired effect. Conclusion: The ultra-short duration of action of remifentanil makes it ideally suited for selected pediatric neurosurgical patients in whom frequent, serial neurological examinations are necessary. There were no side effects associated with the use of remifentanil.