Remifentanil

[deleted9493]

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Did an awake crani the other day using 1mg of remi. over the course of the case...and maybe 20mL of propofol until the patient was in pins and had a good scalp block. I have never worked in place that has carried alfentanil but let me tell you, remi made for a comfortable, interactive patient (with head torqued) for 6 hours. Fentanyl could have done the job, too but I'd have not had the ease of titration...and would have been more likely to deal with facial/nose itching (in my experience).

 

[BuzzPhreed]

The only true case of chestwall rigidity I ever saw with any narcotic was a remi infusion used during a neuromonitoring case in the interventional neuroradiology suite. That was when I was in residency. I used it a lot during residency. Very familiar with the drug. Then I graduated.