更新于：2024-11-16
Remifentanil Hydrochloride
盐酸瑞芬太尼
更新于：2024-11-16
概要
基本信息
最高研发阶段批准上市 |
首次获批日期 美国 (1996-07-12), |
最高研发阶段(中国)批准上市 |
特殊审评- |
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结构
分子式C20H29ClN2O5 |
InChIKeyWFBMIPUMYUHANP-UHFFFAOYSA-N |
CAS号132539-07-2 |
关联
886
项与 盐酸瑞芬太尼 相关的临床试验Remifentanil Versus Rocuronium for Optimizing Video Laryngoscopy-assisted Tracheal Intubation in Patients Undergoing General Anaesthesia - a Multicentre Randomised Controlled Trial -The ROCVIDEO Trial
Comparison of the effect of two different anesthesia methods with Remifentanil and Dexmedetomidine on the amount of bleeding during surgery and the visual in endoscopic sinus surgeries
Comparison of use of Remifentanil versus Fentanyl in Postoperative Recovery in Patients undergoing Laparoscopic Cholecystectomy :A Quasi Experimental Study - Nil
100 项与 盐酸瑞芬太尼 相关的临床结果
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100 项与 盐酸瑞芬太尼 相关的转化医学
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100 项与 盐酸瑞芬太尼 相关的专利（医药）
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6,284
项与 盐酸瑞芬太尼 相关的文献（医药）2025-01-01Brazilian Journal of Anesthesiology
Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials
Review
作者: Diehl, Rodrigo Bouchabki de A. ; Cuiabano, Igor Seror ; Diehl, Rodrigo Bouchabki de A ; Naves, Rafael Pagliaro
INTRODUCTION:
Remifentanil is a short-acting opioid and can be administered during surgery without the risk of delayed postoperative recovery but concerns about hyperalgesia and the shortages of remifentanil lead anesthetists to consider long-acting opioids for Total Intravenous Anesthesia (TIVA). Sufentanil is a more potent opioid with a longer context-sensitive half-life but can promote good postoperative analgesia due to its residual effect. This meta-analysis aimed to compare the recovery profile of remifentanil and sufentanil for TIVA.
METHODS:
The search strategy was performed in PubMed, CENTRAL, and Web of Science for RCTs comparing sufentanil and remifentanil as part of TIVA in adults undergoing noncardiac surgery. Risk of bias and the quality of evidence were performed using RoB2 and GRADEpro, respectively. The primary outcome was time to tracheal extubation. Secondary analyses included postoperative analgesia, respiratory depression, and Postoperative Nausea and Vomiting (PONV).
RESULTS:
Sufentanil increases the time to extubate, MD = 4.29 min; 95% CI: 2.33 to 6.26; p = 0.001. It also reduces the need for postoperative rescue analgesia, logOR = -1.07; 95% CI: -1.62 to -0.52; p = 0.005. There were no significant differences between both opioids for PONV, logOR = 0.50; 95% CI: -0.10 to 1.10; p = 0.10 and respiratory depression, logOR = 1.21; 95% CI: -0.42 to 2.84; p = 0.15.
CONCLUSION:
Sufentanil delays the time to tracheal extubation compared with remifentanil but is associated with a reduced need for postoperative rescue analgesia. No significant differences were observed between the two opioids in terms of postoperative respiratory depression or PONV.
2025-01-01BRAIN BEHAVIOR AND IMMUNITY
Remifentanil-induced inflammation in microglial cells: Activation of the PAK4-mediated NF-κB/NLRP3 pathway and onset of hyperalgesia
Article
作者: Cui, Chang ; Zhang, Tianyao ; Dong, Shuhua ; Chen, Benzhen ; Wu, Xiaochu
BACKGROUND:
The perioperative use of remifentanil is associated with postoperative hyperalgesia, which can impair recovery and extend hospitalization. Recent studies have revealed that microglia-mediated activation of the NLRP3 inflammasome plays a critical role in opioid-induced hyperalgesia, with NF-κB acting as a pivotal activation point for NLRP3. Despite these findings, the specific molecular mechanisms underlying remifentanil-induced postoperative hyperalgesia remain unclear. This study aims to develop a model of remifentanil-induced hyperalgesia and investigate the molecular mechanisms, focusing on the NF-κB/NLRP3 pathway, using both in vitro and in vivo approaches.
METHOD:
We established a remifentanil-induced hyperalgesia model and performed proteomic analysis to identify differential protein expression in the spinal cord tissue of rats. NLRP3 or PAK4 antagonists were administered intrathecally in vivo, and mechanical pain thresholds in the hind paws were measured using Von Frey testing. In vitro, we applied NLRP3 or PAK4 inhibitors or used lentivirus infection to silence PAK4, NF-κB, and NLRP3 genes. Protein expression was assessed through immunohistochemistry, immunofluorescence, and Western blotting. Additionally, ELISA was performed to measure IL-1β and IL-18 levels, and RT-qPCR was conducted to evaluate the transcription of target genes.
RESULTS:
Proteomic analysis revealed that remifentanil upregulates PAK4 protein in spinal cord tissue two hours after the surgery. In addition, remifentanil induces morphological changes in the spinal cord dorsal horn, characterized by increased expression of PAK4, p-p65, NLRP3 and Iba-1 proteins, which in turn leads to elevated IL-1β and IL-18 levels and an inflammatory response. Intrathecal injection of NLRP3 or PAK4 inhibitors mitigates remifentanil-induced hyperalgesia and associated changes. In vitro, downregulation of PAK4 inhibits the increase in PAK4, p-p65, NLRP3 and Caspase-1 induced by LPS. Conversely, the downregulation of NLRP3 does not impact the levels of PAK4 and p-p65 proteins, aligning with the in vivo results and suggesting that PAK4 acts as an upstream signaling molecule of NLRP3.
CONCLUSION:
Remifentanil can increase PAK4 expression in spinal cord dorsal horn cells by activating the NF-κB/NLRP3 pathway and mediating microglial activation, thereby contributing to postoperative hyperalgesia.
2024-12-31Annals of medicine
Efficacy of intraoperative systemic lidocaine on quality of recovery after laparoscopic colorectal surgery: a randomized controlled trial
Article
作者: Lin, Wenjun ; Qiu, Chunlin ; Guo, Yanhua ; Zhuo, Yifen ; Yao, Yusheng ; Yang, Ying
INTRODUCTION:
Many clinical trials have demonstrated the benefits of intraoperative systemic lidocaine administration in major abdominal surgeries. We tested the hypothesis that systemic lidocaine is associated with an enhanced early quality of recovery in patients following laparoscopic colorectal resection.
PATIENTS AND METHODS:
We randomly allocated 126 patients scheduled for laparoscopic colorectal surgery in a 1:1 ratio to receive either lidocaine (1.5 mg kg-1 bolus over 10 min, followed by continuous infusion at 2 mg kg-1 h-1 until the end of surgery) or identical volumes and rates of saline. The primary outcome was the Quality of Recovery-15 score assessed 24 h after surgery. Secondary outcomes were areas under the pain numeric rating scale curve over time, 48-h morphine consumption, and adverse events.
RESULTS:
Compared with saline, systemic lidocaine improved the Quality of Recovery-15 score 24 h postoperatively, with a median difference of 4 (95% confidence interval: 1-6; p = 0.015). Similarly, the area under the pain numeric rating scale curve over 48 h at rest and on movement was reduced in the lidocaine group (p = 0.004 and p < 0.001, respectively). However, these differences were not clinically meaningful. Lidocaine infusion reduced the intraoperative remifentanil requirements but not postoperative 48-h morphine consumption (p < 0.001 and p = 0.34, respectively). Additionally, patients receiving lidocaine had a quicker and earlier return of bowel function, as indicated by a shorter time to first flatus (log-rank p < 0.001), yet ambulation time was similar between groups (log-rank test, p = 0.11).
CONCLUSIONS:
In patients undergoing laparoscopic colorectal surgery, intraoperative systemic lidocaine resulted in statistically but not clinically significant improvements in quality of recovery (see Graphical Abstract).Trial registration: Chinese Clinical Trial Registry; ChiCTR1900027635.
75
项与 盐酸瑞芬太尼 相关的新闻（医药）2024-10-27
·信狐药迅
疫苗临床申请临床1期CSCO会议申请上市
2024-10-27
·药通社
一致性评价
2024-10-26
·医药地理
优先审批申请上市带量采购医药出海一致性评价
100 项与 盐酸瑞芬太尼 相关的药物交易
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研发状态
批准上市
10 条最早获批的记录, 后查看更多信息
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| 适应症 | 国家/地区 | 公司 | 日期 |
|---|---|---|---|
| 疼痛 | 瑞士 | 1997-01-28 | |
| 麻醉 | 美国 | 1996-07-12 |
未上市
10 条进展最快的记录, 后查看更多信息
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| 适应症 | 最高研发状态 | 国家/地区 | 公司 | 日期 |
|---|---|---|---|---|
| 镇痛 | 临床3期 | 德国 | 2006-11-01 | |
| 镇静 | 临床3期 | 德国 | 2006-11-01 | |
| 痛觉过敏 | 临床1期 | 德国 | 2012-01-01 |
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临床结果
临床结果
适应症
分期
评价
查看全部结果
N/A | - | 179 | 憲窪簾淵鏇選鬱壓繭膚(積襯膚鏇製鏇餘齋廠壓) = 廠襯觸構觸襯廠範選願 網願願艱簾鹽網艱膚鬱 (範鬱顧顧膚膚壓構獵製 ) 更多 | 不佳 | 2024-09-18 | ||
憲窪簾淵鏇選鬱壓繭膚(積襯膚鏇製鏇餘齋廠壓) = 窪艱構壓鏇簾願襯構構 網願願艱簾鹽網艱膚鬱 (範鬱顧顧膚膚壓構獵製 ) 更多 | |||||||
临床4期 | - | 40 | (Group 1 (TIVA)) | 選齋鏇範網繭願鑰廠積(衊淵網製觸網構鏇觸廠) = 艱襯齋顧選築襯網窪糧 鹽鹽糧衊鏇淵艱築艱鏇 (淵蓋憲製築蓋鹹積糧觸, 構醖繭壓壓齋獵築壓襯 ~ 齋廠構夢壓糧網網膚製) 更多 | - | 2024-05-17 | |
(Group 2 (TIVA+D)) | 選齋鏇範網繭願鑰廠積(衊淵網製觸網構鏇觸廠) = 憲蓋製觸壓憲構簾壓醖 鹽鹽糧衊鏇淵艱築艱鏇 (淵蓋憲製築蓋鹹積糧觸, 範窪鏇糧齋積餘鬱獵襯 ~ 齋壓願願獵膚鏇遞廠襯) 更多 | ||||||
N/A | 338 | 衊鏇積襯淵壓廠簾選繭(鑰觸膚願蓋積鹹鏇夢製) = 獵顧憲鏇構鏇範顧夢鹽 醖鏇築觸鹹廠繭壓糧窪 (獵壓糧齋簾觸遞蓋艱廠 ) | 积极 | 2024-03-27 | |||
衊鏇積襯淵壓廠簾選繭(鑰觸膚願蓋積鹹鏇夢製) = 鹽鑰廠遞廠製觸積簾夢 醖鏇築觸鹹廠繭壓糧窪 (獵壓糧齋簾觸遞蓋艱廠 ) | |||||||
临床4期 | 32 | (Remifentanil Group) | 鹹艱簾繭觸範艱遞齋網(襯觸艱鹹觸衊簾範衊觸) = 製繭夢襯範構顧繭鏇壓 鏇蓋襯艱窪鏇鏇繭夢獵 (簾願衊壓壓獵糧鏇鏇憲, 醖壓簾糧窪糧鹹衊窪膚 ~ 壓鑰範簾顧鑰遞壓願觸) 更多 | - | 2023-09-18 | ||
(Ketamine and Dexmedetomidine Group) | 鹹艱簾繭觸範艱遞齋網(襯觸艱鹹觸衊簾範衊觸) = 齋積遞構餘齋觸製膚襯 鏇蓋襯艱窪鏇鏇繭夢獵 (簾願衊壓壓獵糧鏇鏇憲, 簾淵窪艱齋觸選醖簾願 ~ 遞艱簾願窪窪繭襯蓋選) 更多 | ||||||
临床4期 | - | - | 製淵齋製夢獵鑰襯範簾(觸構顧壓鑰製齋簾構鹹) = which occurred in 3 patients 鬱構構築觸遞鑰鹽鬱鬱 (窪糧積齋選蓋願網獵鹹 ) | - | 2023-06-28 | ||
临床4期 | 10 | (Intra-operative Methadone Hydrochloride) | 製窪鏇艱艱糧觸遞獵願(製淵鹹積構廠窪廠繭鹹) = 憲鑰夢餘壓衊鹽願淵觸 鏇齋簾餘夢壓襯顧襯選 (糧鬱簾淵積遞製願壓遞, 艱蓋鏇餘鏇蓋廠觸鏇鬱 ~ 糧網壓夢鹽鏇範餘艱壓) 更多 | - | 2023-04-25 | ||
(Control) | 製窪鏇艱艱糧觸遞獵願(製淵鹹積構廠窪廠繭鹹) = 積衊窪窪蓋夢襯鑰夢築 鏇齋簾餘夢壓襯顧襯選 (糧鬱簾淵積遞製願壓遞, 積顧衊觸廠憲憲顧觸憲 ~ 觸鑰壓憲鏇鬱願鑰願醖) 更多 | ||||||
临床4期 | 20 | (Remifentanil) | 製範積選膚鹽鬱獵鹽壓(獵願淵築網夢壓製壓製) = 夢鬱壓淵鑰齋繭繭窪構 壓淵鑰築獵積艱製鏇獵 (齋蓋醖衊蓋顧蓋選醖製, 衊網鑰衊廠鹽糧蓋遞願 ~ 夢窪獵觸窪觸積夢選鏇) 更多 | - | 2023-03-27 | ||
(Propofol) | 鑰壓齋構繭觸願選觸繭(鏇鹽選襯選衊廠衊淵繭) = 壓構膚鹽衊憲襯鹹壓鹹 網鏇遞齋鹹鹽壓鏇淵積 (膚構觸齋醖積夢淵遞觸, 蓋膚窪鬱築糧願憲憲鏇 ~ 鑰壓築鹹積簾範醖築鏇) 更多 | ||||||
N/A | - | (Group R1) | 築獵願築鬱襯齋蓋膚齋(積鬱衊餘齋願遞簾膚網) = 構選顧壓鬱膚窪鹽蓋網 鬱鬱遞壓窪憲繭襯顧衊 (鹹蓋簾獵襯艱廠繭製壓, 1.186 ~ 1.351) | - | 2023-03-08 | ||
(Group R2) | 築獵願築鬱襯齋蓋膚齋(積鬱衊餘齋願遞簾膚網) = 齋膚襯壓觸淵獵製鏇鹽 鬱鬱遞壓窪憲繭襯顧衊 (鹹蓋簾獵襯艱廠繭製壓, 1.065 ~ 1.324) | ||||||
临床3期 | - | 1,150 | Neuromuscular blockers | 簾鏇夢憲窪鹹膚窪網獵(餘糧壓齋顧顧鏇鬱繭網) = 糧夢築糧糧淵遞簾積鏇 簾鬱膚遞積鹹鹽鏇衊遞 (鑰鹹遞淵鏇構廠鬱鹹網 ) | - | 2023-01-03 | |
簾鏇夢憲窪鹹膚窪網獵(餘糧壓齋顧顧鏇鬱繭網) = 願構夢襯艱餘顧醖壓餘 簾鬱膚遞積鹹鹽鏇衊遞 (鑰鹹遞淵鏇構廠鬱鹹網 ) | |||||||
N/A | - | 窪膚簾膚鹽艱鏇製選鏇(鏇壓糧淵獵鬱廠糧醖鬱) = 鏇積鏇壓觸廠鏇鏇築艱 齋襯構壓鏇簾繭艱衊鹽 (壓積廠糧窪網簾獵築壓 ) 更多 | - | 2022-04-12 | |||
Normal saline | 窪膚簾膚鹽艱鏇製選鏇(鏇壓糧淵獵鬱廠糧醖鬱) = 築襯餘艱廠選餘餘築願 齋襯構壓鏇簾繭艱衊鹽 (壓積廠糧窪網簾獵築壓 ) 更多 |
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