Starting with fentanyl for that reason doesn't make much sense.
I use remi all the time. Clinically used doses are 'potent' because it is a short acting drug. Thus, you can get some stiffness, but no different than with any other of the narcotics listed below.
I always mix with propofol and have no problems anyway - 1 mg remi in 50 cc propofol.
Besides, that is what rocuronium or other relaxant is for.
But generally - no relaxant needed with 10cc of the above mixture. (but maybe a little ephedrine).
Regarding end of infusion. You can add some other narcotic or not.
I find that meperidine is great. Knocks out shivering which is more common when recovering from remi infusion.
I use remi all the time. Clinically used doses are 'potent' because it is a short acting drug. Thus, you can get some stiffness, but no different than with any other of the narcotics listed below.
I always mix with propofol and have no problems anyway - 1 mg remi in 50 cc propofol.
Besides, that is what rocuronium or other relaxant is for.
But generally - no relaxant needed with 10cc of the above mixture. (but maybe a little ephedrine).
Regarding end of infusion. You can add some other narcotic or not.
I find that meperidine is great. Knocks out shivering which is more common when recovering from remi infusion.