Delving into the Latest Updates on Remifentanil Hydrochloride with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Afentanil, Aruchiba, Remifentanil

+ [16]

Target

μ opioid receptor

Action

agonists

Mechanism

μ opioid receptor agonists(Mu opioid receptor agonists)

Therapeutic Areas

Nervous System DiseasesOther Diseases

Active Indication

PainAnesthesia

Inactive Indication

AnalgesiaHyperalgesiaSedation

Originator Organization

Abbott Laboratories

Active Organization

GSK PlcJanssen Pharmaceutical KKAspen Pharmacare Holdings Ltd.

+ [2]

Inactive Organization

Air Liquide Santé (International) SA

License Organization-

Drug Highest PhaseApproved

First Approval Date

United States (12 Jul 1996),

Anesthesia

Regulation-

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Structure/Sequence

Molecular FormulaC20H29ClN2O5

InChIKeyWFBMIPUMYUHANP-UHFFFAOYSA-N

CAS Registry132539-07-2

Non-intubated Thoracoscopic surgery (NITS) is a newly emerging minimally invasive surgical technique in recent years . Compared with traditional intubation general anesthesia, it has the advantages of less trauma, faster recovery and fewer complications . This surgical method allows patients to perform under local anesthesia or regional block and moderate sedation, providing a physiologic ventilation method , reducing the intervention on the respiratory system and conducive to rapid postoperative recovery.
The importance of sedative drugs in non-intubated thoracoscopic surgery Successful implementation of non-intubated thoracoscopic surgery requires sound regional block, airway management, and rational use of intravenous sedation and analgesics . In addition, sedative drugs need to have less respiratory and circulatory inhibition and fewer side effects. Propofol, as the most commonly used sedative drug, has a high incidence of adverse reactions such as injection pain and respiratory and circulatory inhibition. A large number of meta-analyses and systematic reviews have compared the sedative effects of remazolam and propofol, proving that Remazolam, as a new sedative, has advantages such as short half-life, rapid onset, rapid recovery, and light respiratory and circulatory inhibition.Compared with traditional benzodiazepines, Remazolam has a shorter half-life, which is conducive to rapid postoperative wakeup and reduces the risk of discomfort and cognitive dysfunction in patients. In addition, remazolam has little influence on the respiratory system and is relatively stable on the circulatory system ?which is an ideal sedation option for non-intubated thoracoscopic surgery that retains spontaneous respiration. Afentanil mainly acts on ? opioid receptors , and its analgesic intensity is about 15 times that of morphine, which has the advantages of rapid onset, short duration of action, rapid recovery, high safety, and few adverse reactions . Afentanil has a short half-life , mild respiratory depression, low incidence of cough, postoperative nausea and vomiting . Remazolam combined with afentanil is widely used in various surgeries or examinations that preserve spontaneous breathing, such as gastroenteroscopy, ERCP, hysteroscopy, short-term plastic surgery and fiberbronchoscopy, and has shown the advantage of light respiratory circulation inhibition . We speculate that remazolam combined with afentanil may have certain advantages in non-intubated thoracoscopic surgery that retains spontaneous breathing. At present, the application of remazolam combined with afentanil in non-intubated thoracoscopic surgery is still lacking. The purpose of this study was to observe the safety and effectiveness of remazolam combined with afentanil in non-intubated thoracoscopic surgery, and to provide a better choice of sedation drugs for non-intubated thoracoscopic surgery.

Start Date01 Dec 2025

Sponsor / Collaborator

Qianfoshan Hospital of Shandong Province

ChiCTR2500111700

/ Not yet recruitingNot ApplicableIIT

Safety and efficacy of remimazolam besylate combined with low-dose esketamine in painless colonoscopy for elderly patients: A prospective, randomized, controlled clinical study

Start Date03 Nov 2025

Sponsor / Collaborator

Liaocheng Peoples Hospital

[+1]

100 Clinical Results associated with Remifentanil Hydrochloride

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100 Translational Medicine associated with Remifentanil Hydrochloride

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100 Patents (Medical) associated with Remifentanil Hydrochloride

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7,355

Literatures (Medical) associated with Remifentanil Hydrochloride

01 Jun 2026·Medical Gas Research

Evaluation of lung dynamics and respiratory functions in patients undergoing minimal flow anesthesia: a prospective, randomized controlled trial

Article

Author: Köksal, Ela Nur Medetoğlu ; Ahiskalioğlu, Elif Oral ; Dişçi, Esra ; Doymus, Omer ; Ahiskalioğlu, Ali ; Çelik, Erkan Cem ; Aydin, Muhammed Enes ; Kerget, Buğra ; Yayik, Ahmet Murat

JOURNAL/mgres/04.03/01612956-202606000-00005/figure1/v/2025-08-20T112310Z/r/image-tiff Low-flow anesthesia aims to minimize anesthetic gas consumption while maintaining adequate anesthesia. To examine the effects of minimal-flow anesthesia on perioperative lung dynamics and postoperative pulmonary function tests, a prospective, randomized controlled study was conducted between October 2023 and March 2024 at Atatürk University. A total of 66 patients (15 males, 45 females) with confirmed American Society of Anesthesiologists (ASA) grade I–II, aged 18–65 years, and scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomized into two groups: MeFA (medium flow anesthesia, 2 L/min fresh gas flow) and MiFA (minimal flow anesthesia, 0.5 L/min fresh gas flow). In both groups, dynamic compliance values, peak inspiratory pressure (PIP) values, total inhalation anesthetic drug consumption, total remifentanil drug consumption, duration of anesthesia, duration of surgery, and spirometry test results were recorded. Respiratory measurements were recorded at the 5th minute after intubation (T1), 5th (T2), 10th (T3), 30th (T4), and 60th (T5) minutes after surgical incision and immediately after the surgical suturing (T6) pulse. There was no significant difference in compliance or PIP values between the groups from T1 to T5 (P > 0.05). However, at T6, the MeFA group exhibited a significant decrease in compliance and an increase in PIP compared with the MiFA group (P < 0.05). Additionally, significant differences in compliance and PIP values were found across all time intervals compared with those at T1, except for the T5–6 compliance values in the MiFA group (P < 0.001). No significant difference in respiratory function test values was noted between the groups (P > 0.05). The MiFA group exhibited a relatively milder reduction in compliance values and a lesser elevation in PIP values. Compared with medium-flow anesthesia, minimal-flow anesthesia may help mitigate perioperative lung function deterioration. These findings suggest potential benefits in preserving lung mechanics, warranting further research. This trial was registered at clinicaltrials.gov (identifier No. NCT06055335, registered March 25, 2023).

31 Dec 2025·ANNALS OF MEDICINE

Efficacy and safety of remimazolam combined with remifentanil for sedation during awake fiberoptic intubation: a randomized controlled trial

Article

Author: Su, Kai ; Zhou, Xiao-Rui ; Li, Cheng-Wen ; Xue, Fu-Shan ; Jin, Mu ; Cheng, Yi

INTRODUCTION:

There has been not study determining if remimazolam combined with remifentanil is the reasonable dosing regimen for sedation during awake fiberoptic intubation (AFOI). This prospective double-blind randomized controlled trial compare efficacy and safety of sedation using different-dose remimazolam combined with remifentanil for AFOI procedure.

METHOD:

One hundred and fifty patients were randomly assigned to five groups receiving different interventions. The Rf group received only remifentanil infusion of 0.05 mcg/kg/min, the Rm group received only remimazolam 0.6 mg/kg/h, and the RR0.2, RR0.4 and RR0.6 groups received remifentanil 0.05 mcg/kg/min combined with remimazolam of 0.2, 0.4 and 0.6 mg/kg/h, respectively. After intravenous infusion of studied drugs for 3 min, AFOI was carried out under airway topical anesthesia. The primary outcome was the incidence of deep sedation during AFOI procedure.

RESULTS:

Deep sedation occurred only in the Rm, RR0.4 and RR0.6 groups, with incidences of 3.3%, 17.2%, and 50.0%, respectively (p < 0.001). The incidence of deep sedation in the RR0.6 group was not statistically different from that in the RR0.4 group (p > 0.05), but was higher than these in the Rf, Rm and RR0.2 groups (p < 0.05). Hypoxemia was observed only in RR0.2, RR0.4 and RR0.6 groups, with incidences of 13.3%, 44.8%, and 44.8%, respectively (p < 0.001). The recall score for AFOI procedure was significantly lower in the four remimazolam groups than in the Rf group (p < 0.005). The patients' reaction score to AFOI procedure, cough severity, incidence of tachycardia, and willingness to repeat the procedure were lower in the RR0.6 group than in the Rf and Rm groups (p < 0.005).

CONCLUSIONS:

Remimazolam 0.2-0.6 mg/kg/h combined with remifentanil 0.05 mcg/kg/min are effective and feasible dosing regimens of sedation for AFOI procedure in patients with normal airway, but the regimen including remimazolam 0.2 mg/kg/h should be the better choice for balancing efficacy and safety.

TRIAL REGISTRATION:

Chinese Clinical Trial Registry, ChiCTR2100042917. Retrieved from http://www.chictr.org.cn/showproj.html?proj=65332 on January 31, 2021.

31 Dec 2025·ANNALS OF MEDICINE

Remifentanil enhances the sedative effect of remimazolam during anesthesia induction in patients undergoing hysteroscopy: a randomized controlled trial

Article

Author: Guan, Xuehai ; Chen, Qiuling ; Cao, Huiyu ; Huang, Xiaofang ; Lin, Yuliu ; Lan, Hongmeng ; Luo, Jiaxin ; Xie, Zhengui ; Zhang, Cuiwen ; Liao, Yeqing

BACKGROUND:

Remimazolam is a novel, short-acting benzodiazepine. This study aimed to investigate whether remifentanil enhances the sedative effect of remimazolam during anesthesia induction in patients undergoing hysteroscopy.

METHODS:

We included 258 adult patients who underwent hysteroscopy. Patients were randomly allocated to three groups (n = 86) in a 1:1:1 ratio. Patients in the saline group received no remifentanil but normal saline during anesthesia induction. Patients in the remifentanil-1 group received low-dose remifentanil (plasma concentration 1 ng/ml), and those in the remifentanil-2 group received higher doses of remifentanil (plasma concentration 2 ng/ml) during anesthesia induction. After reaching the preset plasma concentration of remifentanil, remimazolam was administered (5 mg/kg/h) until loss of consciousness (LOC). During anesthesia maintenance, remimazolam and remifentanil were changed to ensure that the MOAA/S score reached 0. The primary outcome was the time from remimazolam administration to LOC. The secondary outcomes included the doses of remimazolam until LOC, characteristics of the operation and anesthesia, vital signs, and adverse events.

RESULTS:

The time from remimazolam administration to LOC was 154 (139, 180), 120 (104, 139), and 117 (105, 135) s in the saline group, remifentanil-1group, and remifentanil-2 groups, respectively (p < 0.05). The doses of remimazolam until LOC were 12(11, 13), 9.6(8.7, 11), and 8.9(7.9, 10) mg in the saline group, remifentanil-1group, and remifentanil-2 groups, respectively (p < 0.05). There was no significant difference in the characteristic of surgery and anesthesia between groups.

CONCLUSION:

Remifentanil enhances the sedative effect of remimazolam during anesthesia induction in patients undergoing hysteroscopy.

CLINICAL TRIAL REGISTRATION:

The trial was registered at http://www.chictr.org.cn (ChiCTR2200062983).

19

News (Medical) associated with Remifentanil Hydrochloride

09 Apr 2025

·www.echemi.com

Viatris to Pay Up to $335 Million Over Nine Years to Settle Opioid Claims

Viatris has agreed to pay up to $335 million over a nine-year period as part of a nationwide settlement addressing claims from U.S. state and local governments regarding the company’s alleged role in the opioid crisis. The Pennsylvania-based pharmaceutical firm, established through the 2020 merger of Mylan and Pfizer’s Upjohn division, has not admitted to any wrongdoing in connection with this agreement. Under the terms of the settlement, Viatris will contribute between $27.5 million and $40 million annually to support state and local opioid initiatives. New York Attorney General Letitia James, a key figure in the negotiation process, emphasized the importance of this settlement, stating, “While no settlement can fully repair the damage caused by dangerous opioids, these funds will help New York and other states fight the opioid crisis.” Viatris markets opioid products, including the painkiller Ultiva and the Fentanyl Transdermal System, a generic version of Johnson & Johnson’s Duragesic patch. The company is among several pharmaceutical manufacturers accused by state and local governments of downplaying the risks associated with opioid medications. This settlement contributes to the more than $50 billion already secured from various drugmakers, distributors, and pharmacies implicated in the opioid epidemic. Notably, in January, Purdue Pharma and its owners, the Sackler family, reached a $7.4 billion settlement to resolve numerous lawsuits related to their pain medication OxyContin, which has been widely blamed for initiating the crisis. According to the Centers for Disease Control and Prevention, opioid-related overdoses claimed over 80,000 lives in 2023, contributing to a total of 700,000 deaths over the past two decades. This settlement underscores the ongoing efforts to address the devastating impact of the opioid epidemic and hold pharmaceutical companies accountable for their roles in the crisis.

Patent Infringement

14 Mar 2025

·www.echemi.com

5 Key Updates on China's Fentanyl Control Amid US Tariffs

On February 1st, the United States announced a 10% tariff on products imported from China, citing concerns over the fentanyl crisis. In response, a spokesperson from the Ministry of Public Security emphasized that China maintains one of the strictest drug control policies in the world. As a signatory to the three UN drug control conventions, China has consistently upheld its international obligations and actively collaborates with countries, including the US, on drug enforcement efforts. In 2019, China took a humanitarian step by becoming the first country to classify all fentanyl-related substances under stringent controls, responding to US requests. Since this classification, China has not received reports of these substances being seized in the US. On March 12th, the National Medical Products Administration (NMPA) shared insights regarding China's management of fentanyl substances through a recently released white paper. The spokesperson addressed concerns about the production and export of fentanyl-related pharmaceuticals. Currently, four fentanyl-related drugs are approved for clinical use in China: fentanyl, sufentanil, remifentanil, and alfentanil. Three companies have been authorized to produce raw materials, while five are permitted to manufacture formulations. In 2024, China produced 100 kilograms of fentanyl raw materials, primarily for domestic medical use and export, with only 12.3 kilograms exported to countries like South Korea, Vietnam, and the Philippines. Notably, China has never exported fentanyl products to North America. All fentanyl-related drugs in China are classified as controlled narcotics, subjected to stringent regulations. The production and distribution of these drugs are closely monitored, with specific companies designated for manufacturing and fixed sales channels established. Export controls require permits, and international verification ensures the legality of trade before issuing export licenses. The NMPA will continue to enhance the supervision of fentanyl-related drug production and strictly regulate exports to prevent illegal channels and misuse, ensuring that medical needs are met responsibly.

Drug Approval

06 Mar 2025

·www.drugs.com

Intraoperative Remifentanil, Sufentanil Tied to Poor Postoperative Pain Experience

THURSDAY, March 6, 2025 -- For patients undergoing elective surgery , intraoperative use of remifentanil and sufentanil is independently associated with a poorer postoperative pain experience, according to a study published online Feb. 25 in Regional Anesthesia & Pain Medicine . Axel Maurice-Szamburski, M.D., Ph.D., from the University Hospital Centre Nice Pasteur Hospital in France, and colleagues conducted an exploratory secondary analysis using data from 971 adults undergoing elective surgery under general anesthesia across five hospitals to identify factors associated with poor postoperative pain experience. Patient experience measured by the Evaluation du Vécu de l'Anesthésie Generale questionnaire on postoperative day 1 was the primary end point. The researchers found that 27.9 percent of patients reported poor pain experience. Intraoperative use of remifentanil and sufentanil was identified as an independent predictor of poor pain experience in a multivariate analysis. Age, absence of premedication, and orthopedic surgery were associated with a significantly lower likelihood of poor pain experience. In contrast, predictors of poor pain experience included American Society of Anesthesiologists 3 status, postoperative anxiolytic use, amnesia, higher visual analog scale pain, and lower well-being scores on day 1. "These findings underscore the need to reassess intraoperative analgesic strategies to reduce postoperative complications and improve patient care," the authors write. "Further research is required to confirm these associations and to develop optimized perioperative pain management protocols focused on enhancing patient outcomes."

Clinical Result

100 Deals associated with Remifentanil Hydrochloride

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External Link

KEGG	Wiki	ATC	Drug Bank
D01177	Remifentanil Hydrochloride	N01AH06	DB00899

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Pain	Switzerland	GSK Plc	28 Jan 1997
Anesthesia	United States	Mylan Institutional LLC	12 Jul 1996

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Analgesia	Phase 3	Germany	GSK Plc	01 Nov 2006
Sedation	Phase 3	Germany	GSK Plc	01 Nov 2006
Hyperalgesia	Phase 1	Germany	Air Liquide Santé (International) SA	01 Jan 2012

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT04364945 (Pubmed \| Anesthesiology)	Not Applicable	-	343	Dexmedetomidine and Remifentanil as adjuncts to Sevoflurane	boqmyfsngv(mjnchtvtam) = No significant difference was observed between groups rcltqhvvmb (stizfinfdf )	Positive	01 Oct 2025
				Sevoflurane alone
NCT05391555 (CTgov)	Phase 2/3	Opioid-Related Disorders \| Miosis \| Respiratory Insufficiency	10	Pupillometry measurement+Remifentanil Hydrochloride	bujzgqarhc = xnjtqtkqxy wrwtwqpvqy (gbrwzpapkb, fycuebsndd - mjtdyhadja) View more	-	02 May 2025
NCT02898792 (Pubmed \| Br J Anaesth)	Early Phase 1	Sleep Apnea, Obstructive	-	remifentanil (Adult volunteers without OSA)	rylhrqkssp(xibftnakbd) = eskcqdifia fjpzlanfau (yuufyhowmq ) View more	Positive	01 Mar 2025
				remifentanil (Adult volunteers with untreated OSA)	rylhrqkssp(xibftnakbd) = heshrxwqie fjpzlanfau (yuufyhowmq ) View more
NCT04734418 (Pubmed \| J Intensive Care) Manual	Not Applicable	-	179	Remifentanil	kkxsumeipl(ssiqucinkd) = yvzrgapigo iepkvuxyoj (qqhaggatsa ) View more	Negative	18 Sep 2024
				Dexmedetomidine	kkxsumeipl(ssiqucinkd) = bfywvfrgpt iepkvuxyoj (qqhaggatsa ) View more
NCT02631135 (CTgov)	Phase 4	-	40	Propofol+Rocuronium+Remifentanil (Group 1 (TIVA))	dxoftbjhph(fsukcbhbfe) = cmvwsplirt fetfkvwqxy (nluuijqtpj, 1.31) View more	-	17 May 2024
				Dexmedetomidine+Propofol+Rocuronium+Remifentanil (Group 2 (TIVA+D))	dxoftbjhph(fsukcbhbfe) = rnopqykmxw fetfkvwqxy (nluuijqtpj, 1.19) View more
NCT03207100 (Pubmed) Manual	Not Applicable	Cerebral Hemorrhage	338	remifentanil grdexmedetomidineil and dexmedetomidine)	omdkgoeruo(xswkcxyxpy) = lmjxcilshr gokhfxftaa (duruknmmfw )	Positive	27 Mar 2024
				remifentanil (Control group (standard guideline-based management))	omdkgoeruo(xswkcxyxpy) = eagchclxhd gokhfxftaa (duruknmmfw )
ChiCTR2200064932 (Pubmed \| BMC Anesthesiol)	Not Applicable	-	-	Esketamine	bpodcaieni(hahsxcqbzu) = tinfxrfoez nlmbscbjvc (tiesldrtzx, 3.22 - 3.99) View more	-	21 Feb 2024
				Control (physiological saline)	bpodcaieni(hahsxcqbzu) = mqcoowlpcj nlmbscbjvc (tiesldrtzx, 3.59 - 4.33) View more
NCT03643796 (CTgov)	Phase 4	Intervertebral Disc Disease	32	Remifentanil (Remifentanil Group)	nazamikcap = edxqinufkn msfuauqamq (bmhwbznsly, purzspqalc - vxfdigdhbh) View more	-	18 Sep 2023
				Dexmedetomidine+Ketamine (Ketamine and Dexmedetomidine Group)	nazamikcap = ilsylengsq msfuauqamq (bmhwbznsly, apogvhyhvl - ogxnfmowfs) View more
ChiCTR2100054565 (Pubmed \| BMC Anesthesiol)	Phase 4	-	-	Remifentanil	xzwcsuqqfm(yxbuvqiari) = which occurred in 3 patients fkziqlwyok (quzghzvpni )	-	28 Jun 2023
NCT02989597 (MAPS, CTgov)	Phase 4	Pain, Postoperative	10	Spinal Fusion Surgery+Sufentanil+Dexamethasone+Methadone Hydrochloride+Ketamine+Remifentanil (Intra-operative Methadone Hydrochloride)	ozurehrgvg(jcnpprtnfs) = zjhfknewlg pjxrxuybkc (uqixweceye, zzaazqryte - lqyxyxkmhz) View more	-	25 Apr 2023
				Spinal Fusion Surgery+Sufentanil+Dexamethasone+Ketamine+Remifentanil (Control)	ozurehrgvg(jcnpprtnfs) = fmiyhzijpv pjxrxuybkc (uqixweceye, ivtdmzxmti - vfwwsbyrui) View more