<unk>  is considered a metabolic soft drug, one that is rapidly metabolized to an inactive form. Unlike other synthetic opioids which are hepatically metabolized,<unk>  has an ester linkage which undergoes rapid hydrolysis by non-specific tissue and plasma esterases. This means that accumulation does not occur with<unk>  and its context-sensitive half-life remains at 4 minutes after a 4-hour infusion.<unk>  is metabolized to a compound<unk>  acid) which has 1/4600th the potency of the parent compound. Due to its quick metabolism and short effects,<unk>  has opened up new possibilities in anesthesia. When<unk>  is used together with a hypnotic (i.e. one that produces sleep) it can be used in relative high doses. This is because<unk>  will be rapidly eliminated from the blood plasma on termination of the<unk>  infusion, hence the effects of the drug will quickly dissipate even after very long infusions. Owing to synergism between<unk>  and hypnotic drugs (such as propofol) the dose of the hypnotic can be substantially reduced. This leads often to more hemodynamic stability during surgery and a quicker post-operative recovery time.
Remifentanil
Propofol
Fentanyl
Etomidate
Alfentanil
Ketamine
Metharbital
Sevoflurane