On 2014 Sep 16, Mohamed Soliman commented:

I am using remifentanil frequently in monitored anesthesia care alone or in combination with propofol. Occasioally, I use it as a rescue analgesic in special circumstances. In some patients who represent a high risk for general anesthesia, a remifentanil infusion in addition to a local anesthetic were successfully used. The remifentanil infsuion rate should be carefully titrated according to respiratory rate, sedation level and patient analgesic need. Standard anesthesia monitoring including End-tidal Carbon Dioxide should be used.

On 2014 Sep 16, Mohamed Soliman commented:

I am using remifentanil frequently in monitored anesthesia care alone or in combination with propofol. Occasioally, I use it as a rescue analgesic in special circumstances. In some patients who represent a high risk for general anesthesia, a remifentanil infusion in addition to a local anesthetic were successfully used. The remifentanil infsuion rate should be carefully titrated according to respiratory rate, sedation level and patient analgesic need. Standard anesthesia monitoring including End-tidal Carbon Dioxide should be used.