Remifentanil is ideal for transient suppression of sympathetic stimulation during laryngoscopy.

Remifentanil is ideal for transient suppression of sympathetic stimulation during laryngoscopy.

• A. True
• B. False
• C. Not recommended
• D. Only in combination with muscle relaxant

Answer: (D)

Remifentanil blunts the hemodynamic surge from laryngoscopy by reducing sympathetic catecholamine release, and its ultra-short action lets that suppression be brief and recover quickly after the stimulus ends. To achieve reliable, smooth laryngoscopy and intubation, this opioid is used in concert with a muscle relaxant (often with a hypnotic as well). The muscle relaxant prevents movement and preserves optimal airway conditions, while the opioid keeps the reflex pressor response in check. Without a muscle relaxant, airway reflexes and movement can still occur, making the suppression incomplete and the procedure less stable. Thus, remifentanil is best used only in combination with a muscle relaxant for transient suppression during laryngoscopy.

Remifentanil blunts the hemodynamic surge from laryngoscopy by reducing sympathetic catecholamine release, and its ultra-short action lets that suppression be brief and recover quickly after the stimulus ends. To achieve reliable, smooth laryngoscopy and intubation, this opioid is used in concert with a muscle relaxant (often with a hypnotic as well). The muscle relaxant prevents movement and preserves optimal airway conditions, while the opioid keeps the reflex pressor response in check. Without a muscle relaxant, airway reflexes and movement can still occur, making the suppression incomplete and the procedure less stable. Thus, remifentanil is best used only in combination with a muscle relaxant for transient suppression during laryngoscopy.