In clinical practice, coadministration of sevoflurane or propofol could antagonize remifentanil stimulation of N-methyl-D-aspartate receptors.

In modern clinical practice, remifentanil-based anesthesia is performed administering either propofol or sevoflurane as adjuvants. Data, taken together, support the hypothesis that propofol or sevoflurane, coadministered with remifentanil during anesthesia, produced an inhibiting effect at NMDA receptors antagonizing remifentanil-related stimulation. It is also in accord with a number of recent clinical studies suggesting that administration of remifentanil is also safe in neurosurgery, neuro–intensive care unit sedation, and postoperative analgesia after craniotomy.