400 Remifentanil
that it might appeal only to abusers seeking short spurts of sensation. Al-
though the researchers implied that limited access to necessary safe dosage
equipment might deter illicit use of remifentanil, safety concerns are not uni-
versal among drug abusers.
Drug interactions.Not enough scientific information to report.
Cancer.The drug’s ability to cause cancer is uncertain. Most laboratory tests
reveal no potential for cancer from remifentanil, although one type of labo-
ratory test using mouse cells does give positive results.
Pregnancy.Decline in fertility was observed among male rats that received
remifentanil daily for over two months at doses 40 times the recommended
human level. No birth defects were attributed to the drug when pregnant
rabbits received 125 times the recommended human dose. The same negative
result occurred when rats received 400 times the maximum human dose. In
both species the drug passed into the fetus. Those offspring, in turn, developed
and reproduced normally. Effects on human pregnancy are unknown. One
study observed no ill effect in infants when women received remifentanil dur-
ing childbirth, but another study found the drug to have such a negative
impact on women giving birth (itching, vomiting, low oxygen level in blood,
and insufficient pain relief) that the experiment was abandoned. The drug
passes into the milk of rats, but whether it passes into human milk is un-
known.
Additional scientific information may be found in:Baylon, G.J., et al. “Comparative Abuse Liability of Intravenously Administered Re-
mifentanil and Fentanyl.”Journal of Clinical Psychopharmacology20 (2000): 597–
606.
Black, M.L., J.L. Hill, J.P. Zacny. “Behavioral and Physiological Effects of Remifentanil
and Alfentanil in Healthy Volunteers.”Anesthesiology90 (1999): 718–26.
Ferguson, C.N., and R.M. Jones. “Remifentanil—Introduction and Preclinical Studies.”
Drugs Today33 (1997): 603–9.
Guignard, B., et al. “Acute Opioid Tolerance: Intraoperative Remifentanil Increases
Postoperative Pain and Morphine Requirement.” Anesthesiology 93 (2000):
409–17.
Patel, S.S., and C.M. Spencer. “Remifentanil.”Drugs52 (1996): 417–27.
Puckett, S.D., and J.J. Andrews. “AANA Journal Course: Update for Nurse Anesthe-
tists—A Comprehensive Review of Remifentanil: The Next Generation Opioid.”
AANA Journal66 (1998): 125–36.