Epidural sufentanil for intra– and postoperative analgesia in thoracic surgery: a comparative study with intravenous sufentanil

Rosseel, Peter; Broek, W. G. M. Van Den; Boer, Emma C.; Prakash, O.

doi:10.1111/j.1399-6576.1988.tb02713.x

Cited by 37 publications

(13 citation statements)

References 33 publications

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“…Intrathecally, the estimated onset time dropped to 1.5 min. However, the duration of analgesia also clearly declined over time to33.5 (TWR latency >6.0 s) and 20.5 min (TWR latency 2 10.0 s), respectively. With morphine, onset times of 12 and 19 min were calculated epidurally for a T W R latency >6.0 and 2 10.0 s, with corresponding durations of analgesia of 50 and 45 min.…”

mentioning

confidence: 95%

Spinal sufentanil in rats: part I: epidural versus intrathecal sufentanil and morphine

Boersma

Meert

Vercauteren

1992

Acta Anaesthesiol Scand

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Male Wistar rats were injected epidurally or intrathecally with increasing doses of sufentanil or morphine in order to determine differences in potency, onset and duration of analgesia and supra-spinal side-effects. For sufentanil, only small differences in the lowest ED50-values for analgesia and supra-spinal side-effects were observed between the two spinal routes. Given intrathecally, sufentanil had a somewhat faster onset but a shorter duration of action than did epidural sufentanil. However, intrathecal morphine when compared to epidural morphine had a faster onset with a greater potency and a longer duration of action. The stronger opioid activity of intrathecal morphine was also reflected in a reduced safety ratio for the blockade of the cornea reflex. These differences between the two opioids, with regard to their optimal route of spinal administration, are discussed in terms of lipophilicity and optimal clinical use.

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mentioning

confidence: 95%

Spinal sufentanil in rats: part I: epidural versus intrathecal sufentanil and morphine

Boersma

Meert

Vercauteren

1992

Acta Anaesthesiol Scand

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“…There were no differences in episodes of tachycardia and hypertension. The mean sufentanil requirements during surgery were higher than the intraveneous sufentanil increments after 0.7 /~g/kg epidural bolus in the study of Rosseel et al [11]. …”

Section: Intraoperative Studymentioning

confidence: 90%

Epidural fentanyl and sufentanil for intra- and postoperative analgesia

Wilhelm¹,

Dieleman²

1994

Pharm World Sci

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In a double-blind, randomized study the efficacies of concentrated fentanyl and sufentanil injections as intraoperative epidural analgesics were compared. Also, the equivalent dose of fentanyl and sufentanil administered by continuous infusion during the first 24 h postoperatively, expressed in analgesia and also considering the side-effects was determined. 53 Patients undergoing elective thoracotomy, aortic surgery and bowel surgery were randomized and treated double-blind with fentanyl 0.250 mg/ml or sufentanil 0.05 mg/ml. Preoperatively, 0.5-1 ml study medication was administered, followed by increments of 0.2-0.5 ml during surgery guided by heart rate and systolic blood pressure. Postoperatively, study medication diluted in 1.25 mg/l bupivacaine was administered by continuous epidural infusion. The infusion rate was adjusted to optimize analgesia. Dose, heart rate and systolic blood pressure were measured intra- and postoperatively. Pain, sedation, nausea and pruritus were assessed on a 10 cm visual analogue scale. There were no differences in required volume of study medication, heart rate and systolic blood pressure nor in the parameters assessed postoperatively. Administered doses were 27.5 micrograms/h fentanyl and 5.5 micrograms/h sufentanil. It was concluded that 0.250 mg/ml (0.74 mumol/ml) fentanyl is clinically equivalent to 0.050 mg/ml (0.13 mumol/ml) sufentanil.

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“…Opioids are often combined with epidural local anesthetics to improve the quality of analgesia and decrease local anesthetic requirements and motor blockade [36]. Analgesics are administered via epidural route to obtain selective spinal analgesia and limit systemic side effects [38]. For many years and also nowadays, morphine represents the "gold standard" opioid for neuraxial analgesia in the obstetric setting and major surgery [39,40].…”

Section: Opioidsmentioning

confidence: 99%

New Drugs for Epidural Analgesia

Congedo

Sgreccia

Cosmo

2009

CDT

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In recent years there has been a wide use of the epidural technique not only during surgery to provide anesthesia and analgesia, but also for obstetric and trauma as well as acute, chronic and cancer pain states. Nowadays there is an increase in the number of the epidural drugs. Local anesthetics and opioids are still the pharmacological agents more widely used epidurally, nevertheless other drugs from different pharmacological classes are administered as adjuvant to local anesthetics and opioids or are in various early stages of investigation. Regarding to local anesthetics, the most recent literature focuses on the new enantiomers, ropivacaine and levobupivacaine, the efficacy of which is similar to that of bupivacaine with a reduced risk of cardiotoxicity. About opioids, the other class of drugs mainly used, the debate, in the last years, concerned the physicochemical properties of morphine and of the more recent lipophilic agents, fentanyl and sufentanil, in order to explain the main differences in efficacy and safety. Other categories of agents have been investigated for epidural administration, such as alpha(2)-adrenergic agonists clonidine and dexmedetomidine. They are being used increasingly as adjuvants to local anesthetics and opioids. Ketamine and neostigmine, the more recent studied drugs for epidural use, are still under investigation and are not part of routine clinical practice.

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Epidural sufentanil for intra– and postoperative analgesia in thoracic surgery: a comparative study with intravenous sufentanil

Cited by 37 publications

References 33 publications

Spinal sufentanil in rats: part I: epidural versus intrathecal sufentanil and morphine

Spinal sufentanil in rats: part I: epidural versus intrathecal sufentanil and morphine

Epidural fentanyl and sufentanil for intra- and postoperative analgesia

New Drugs for Epidural Analgesia

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