Which property of remifentanil makes it attractive as an analgesic component of MAC for brief painful procedures?

• A Long context-sensitive half-time allowing smooth post-procedure analgesia
• B Active metabolite providing prolonged analgesia after stopping the infusion
• C Selective kappa receptor agonism avoiding respiratory depression
• D Metabolism by nonspecific plasma esterases giving rapid offset regardless of infusion duration ✓

Explanation

Remifentanil is hydrolysed by nonspecific blood and tissue esterases to an essentially inactive metabolite, so its context-sensitive half-time stays around 3 to 4 minutes irrespective of infusion length, permitting precise titration and fast recovery. This same property means analgesia vanishes abruptly, requiring planned transition to longer-acting opioids, which refutes option A. It is a mu agonist with marked respiratory depression and has no active metabolite.

Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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