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Alfentanil context-sensitive offset — FRCA Primary MCQ

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HardPharmacologyAlfentanil context-sensitive offsetFRCA Primary

At the end of a short procedure, remifentanil is stopped without another analgesic. What is the most likely consequence?

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Correct answer: E — Analgesia wears off rapidly, so alternative analgesia should be planned

The best answer is “Analgesia wears off rapidly, so alternative analgesia should be planned”. Remifentanil is cleared by non-specific esterases and has an essentially inactive metabolite, so its analgesic effect ends rapidly when the infusion stops. It provides little residual postoperative analgesia; a separate analgesic plan is needed before discontinuation.

Reference: Remifentanil 1 mg, Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/794/smpc