Alfentanil Infusion for Sedation and Analgesia in Intensive Care

Yate, P.M.; Thomas, David Mathew; Sebel, P.S.

doi:10.1016/s0140-6736(84)90558-0

Cited by 14 publications

(9 citation statements)

References 5 publications

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“…However, it is suggested by the significant increase in the number of changes in rate with the pethidine group that the sedation was easier to achieve with alfentanil. The infusion rates of alfentanil required were in the range 0.4-0.5 ug kg" + 1 min" 1similar to those reported previously (Yate, Thomas and Sebel, 1984) with unsupplemented alfentanil, although supplemented with midazolam in the present study. Although the previous report suggested that alfentanil could be used as the sole agent, midazolam had to be added in the pethidine group for satisfactory sedation, and in an effort to maintain comparability between the groups midazolam was given to the alfentanil patients as well.…”

Section: Discussionsupporting

confidence: 87%

Comparison of Infusions of Alfentanil or Pethidine for Sedation of Ventilated Patients on the Itu

Yate

Short

Sebel

et al. 1986

British Journal of Anaesthesia

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Sedation was studied in 30 patients requiring overnight ventilation in the intensive therapy unit (ITU). Patients received an infusion of either alfentanil or pethidine, supplemented with midazolam. The infusion rates were adjusted to provide optimal sedation as judged by a nurse, and measurements were made of quality of sedation, recovery and serum cortisol concentration. In addition, blood concentrations of alfentanil were measured to permit pharmacokinetic and pharmacodynamic analysis. Satisfactory sedation was achieved in both groups. The required infusion rate for alfentanil was between 0.4 and 0.5 micrograms kg-1 min-1. Recovery was good in both groups, apart from one patient in the alfentanil group, in whom recovery was greatly prolonged and alfentanil pharmacokinetics were abnormal. A difference was found in the metabolic response to surgery between the two groups, the response in the alfentanil group being significantly less marked.

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Section: Discussionsupporting

confidence: 87%

Comparison of Infusions of Alfentanil or Pethidine for Sedation of Ventilated Patients on the Itu

Yate

Short

Sebel

et al. 1986

British Journal of Anaesthesia

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“…A very large range of recovery times in both groups is evident, and demonstrates the difficulties in making predictions on recovery from drugs with a short halflife, such as alfentanil. Prolonged recovery after alfentanil infusions has been reported by other authors [4,14].…”

Section: Discussionsupporting

confidence: 64%

“…These patients differ from those in general intensive care units in that they are generally more fit (with the exception of cardiac pathology) and rarely have significant renal or hepatic disease, hence drug elimination is less of a problem. For these reasons, studies of sedation are often undertaken in this group [4,5,7]. Agents that cause excessive or prolonged sedation should be avoided if possible, because these patients are usually transferred from the ICU the day after operation.…”

Section: Discussionmentioning

confidence: 99%

Sedation Following Cardiac Surgery: Evaluation of Alfentanil and Morphine in the Presence of a Computerized Closed Loop Arterial Pressure Controller

McMenemin

Church

1988

British Journal of Anaesthesia

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Forty patients who had undergone coronary artery graft surgery and who required vasodilator therapy for postoperative hypertension were given infusions of either alfentanil or morphine together with bolus doses of midazolam for sedation and analgesia while ventilation was controlled artificially. Sodium nitroprusside (SNP) was administered to both groups using a computer-controlled closed loop system which adjusted the infusion rate to maintain a preset target arterial pressure. Target pressure +/- 5, 10, 15 and 20 mm Hg was maintained longer in the group receiving alfentanil. This group also required less SNP per hour. No difference was noted between the groups in the time taken to regain spontaneous ventilation and to extubation of the trachea, although the alfentanil group tended to be sedated more deeply during the infusion. The main advantage of alfentanil over morphine at doses used in this study was its superior ability to attenuate hypertensive responses to noxious stimuli, providing improved haemodynamic stability.

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“…Sufficient sedation was defined as the administration of midazolam (Dormicum) at doses Ն0.1 mg/kg body weight (10), etomidate (Hypnomidate) at doses Ն0.2 mg/kg body weight (11), or propofol (Diprivan) at doses Ն1 mg/kg body weight (12). Sufficient analgesia was defined as the use of fentanyl (Fentanyl) at doses Ն1 g/kg body weight (13). The exact administration time of sedative and/or analgesic drugs was registered.…”

Section: Methodsmentioning

confidence: 99%

Life after death: Posttraumatic stress disorder in survivors of cardiac arrest—Prevalence, associated factors, and the influence of sedation and analgesia

Gamper¹,

Willeit²,

Sterz³

et al. 2004

Critical Care Medicine

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Alfentanil Infusion for Sedation and Analgesia in Intensive Care

Cited by 14 publications

References 5 publications

Comparison of Infusions of Alfentanil or Pethidine for Sedation of Ventilated Patients on the Itu

Comparison of Infusions of Alfentanil or Pethidine for Sedation of Ventilated Patients on the Itu

Sedation Following Cardiac Surgery: Evaluation of Alfentanil and Morphine in the Presence of a Computerized Closed Loop Arterial Pressure Controller

Life after death: Posttraumatic stress disorder in survivors of cardiac arrest—Prevalence, associated factors, and the influence of sedation and analgesia

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