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Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Sufentanil has a profound parasympathotonic effect (bradycardia, hypotension) that may be reversed by atropine. Intranasal sufentanil (1–2 mcg/kg) has been used for sedation during minor procedures under local anaesthesia but is associated with prolonged recovery room stay [169,170]. Doses of 0.5–1 mcg/kg are used to supplement volatile agents during general anaesthesia, with up to 20 mcg/kg used during cardiac surgery with minimal cardiac depressant effect [171,172]. Epidural sufentanil 0.75 mcg/kg produces an analgesic effect in 3 min lasting up to 200 min in children 4–12 years [173].
Drugs Affecting the Musculoskeletal System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: It should be used with caution during the 1st and 2nd Trimesters. However, it is better to avoid the use of Sufentanil near term because of the risk of neonatal respiratory depression if used close to delivery.
Local Anesthetics and Additives
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Jean-Pierre Haberer, Bernard Jacques Dalens
The respiratory depression produced by the epidural administration of 0.75 μg/kg of sufentanil in children is time-related (Figure 3.23).112 The ventilatory depression parallels the rostral spread of periosteal analgesia (Figure 3.24), which suggests a rostral spread of lipid-soluble narcotics along the neuraxis as previously observed with epidural morphine.112,140,158 Such a spread may occur either by diffusion within the cerebrospinal fluid or through direct perimedullary channels.
Isoflurane not at the expense of postoperative nausea and vomiting in cardiac anesthesia – an observational study
Published in Current Medical Research and Opinion, 2021
Christine H. Meyer-Frießem, Sabeth Hüsken, Miriam Kaisler, Nathalie M. Malewicz, Peter K. Zahn, Andreas Baumann
Anesthesia was introduced with 5 mg midazolam, 1 mg/kg propofol, 0.5 µg/kg sufentanil (both calculated by ideal body weight) and 8 mg pancuronium. Also administered directly after successful intubation and not adapted to body weight was a recommended drug prophylaxis with 4 mg dexamethasone directly after induction and 0.625 mg droperidol at the end of surgery7. Implemented doses were in accordance with the guidelines for general surgery7. Isoflurane was established with a target minimum alveolar concentration (MAC) of 0.8, orientated on a bispectral index (BIS; 0–100) of 40–6032,33. During cardiopulmonary bypass, isoflurane was applied via extracorporeal circulation, if appropriate. For analgesia, sufentanil was applied continuously throughout the entire surgical period in an amount of approximately 0.5 µg/kg/h.
Sublingual analgesia: a promising proposal for the treatment of pain
Published in Expert Opinion on Drug Delivery, 2020
Sufentanil has not been typically used outside of the operating room and isn’t usable in typical pain treatment as an IV drug due to its high Cmax. As a sublingual drug, however, patients can get the benefit of its lack of breakdown products, plus its longer duration of action than fentanyl. This combined with its low Cmax relative to therapeutic levels and low adverse event rates that have been described make it a very promising agent for the treatment of acute pain in situations when an IV isn’t available or otherwise needed and an opioid without active metabolites is needed.
Real-world use of the sufentanil sublingual tablet system for patient-controlled management of acute postoperative pain: a prospective noninterventional study
Published in Current Medical Research and Opinion, 2020
Esther Pogatzki-Zahn, Peter Kranke, Judit Winner, Wolfgang Weyland, Alexander Reich, Ursula Vigelius-Rauch, Michael Paland, Thorsten Löhr, Leopold Eberhart
Sufentanil is a μ-opioid agonist with a high therapeutic index in preclinical studies and with physicochemical properties and a pharmacokinetic profile which make it suitable for the transmucosal route of administration. Its highly lipophilic properties result in a rapid onset of action and a short plasma/central nervous system equilibration half-life; in addition, sufentanil has no active metabolites and low tissue accumulation10–14,16.