Provider notes

• NMUH:
  
  • No restriction stated
• RFL:
  
  • Restricted to Anaesthetics and Palliative Care only 
• RNOH:
  
  • No restriction stated
• UCLH:
• WH:
  
  • No restriction stated

Provider notes

• NMUH:
  
  • No restriction stated
• RFL:
  
  • No restriction stated
• RNOH:
  
  • Restricted Only on the recommendation of the Pain Team for patients intolerant to or with contraindications to morphine and oxycodone
• UCLH:
• WH:
  
  • No restriction stated

Provider notes

• NMUH:
  • For use in ICU (Intensive Care Unit) ONLY
• RFL:
  • No restriction stated
• RNOH:
  • No restriction stated
• UCLH:
• WH:
  • CD = Controlled drug. The Misuse of Drug Regulations apply. For further details see. Prescribing Guidelines. Ideally, remifentanil should be administered as an infusion, either with a standard syringe driver or as a Target Controlled Infusion using the Minto pharmacokinetic model (with the Alaris PK pump). Remifentanil should be diluted before administration, typically to a concentration of 20 to 40 mcg/ml, though higher concentrations can be used. A recommended induction infusion rate is 0.5 mcg/kg/min or8 ng/ml target for a ventilated patient and the rate halved for maintenance and titrated to clinical need (considerably higher or lower rates may be required). Beware the elderly or those with significant comorbidity when initial rates should be reduced. A dedicated cannula or antireflux valve should be used if an IV cannula is shared with fluids or other drugs. The cannula and giving set should be flushed at the end of use to avoid boluses of remifentanil accidentally being administered postop. Boluses of remifentanil should be administered carefully, by slow injection over a period of 30 to 60seconds.