Pharmacokinetics of long-term sufentanil infusion for sedation in ICU patients

Ethuin, Fréderic; Boudaoud, S.; Leblanc, Isabelle; Troje, Christian; Marie, Olivier; Levron, Jean-Claude; Moing, Jean-Pierre Le; Assoune, P.; Eurin, B; Jacob, Laurent

doi:10.1007/s00134-003-1920-y

Cited by 32 publications

(23 citation statements)

References 21 publications

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“…Therefore, the risk of respiratory depression associated with longer acting opioids or centrally acting drugs was avoided. The context sensitive sufentanil half-life increased as the administration duration increased [26]. Therefore, surgical specimen procurement was the designated sufentanil start time in order to reduce the administration duration while still achieving the target concentration.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Sufentanil Administration on Remifentanil-Based Anaesthesia during Laparoscopic Gynaecological Surgery: A Double-Blind Randomized Controlled Trial

Son

Choi

et al. 2014

The Scientific World Journal

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This study assessed the effect of sufentanil administered before conclusion of remifentanil-based anaesthesia on postoperative hyperalgesia and haemodynamic stability in patients undergoing laparoscopic gynaecological surgery. The patients were randomly allocated to a sufentanil administration group (S group) or a normal saline administration group (C group). Anaesthesia was induced and maintained with controlled administration of remifentanil at 10 ng·mL−1 and propofol under bispectral index guidance. Once the surgical specimen was procured, sufentanil or normal saline was administered at 0.15 ng·mL−1 and maintained until extubation. The haemodynamic status during anaesthetic emergence was evaluated. The pain and postoperative nausea and vomiting (PONV) were assessed for 72 h following postanaesthetic care unit (PACU) discharge. The S group had significantly lower mean systemic arterial blood pressure and heart rate changes between the start of drug administration and extubation. Postoperative pain was significantly lower in the S group until 24 h following PACU discharge. There were no significant differences in PONV incidence and severity 72 h after PACU discharge between the two groups. Sufentanil administration before concluding remifentanil-based anaesthesia improved postoperative hyperalgesia and achieved haemodynamic stability at extubation without delaying recovery or increasing PONV during laparoscopic gynaecological surgery. Clinical trial registration is found at KCT0000785.

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Section: Resultsmentioning

confidence: 99%

The Effect of Sufentanil Administration on Remifentanil-Based Anaesthesia during Laparoscopic Gynaecological Surgery: A Double-Blind Randomized Controlled Trial

Son

Choi

et al. 2014

The Scientific World Journal

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“…[15] studied the pharmacokinetics of long-term sufentanil infusion for sedation in ICU patients and found that rapid distribution and elimination process are responsible for rapid reversibility of sedation with sufentanil maintained after long duration infusion.…”

Section: Discussionmentioning

confidence: 99%

“…[15] in their study found that sufentanil suitable only for intensive-care patients with a short stay in ICU. Respiratory depression during spontaneous breathing is not significant.…”

Section: Discussionmentioning

confidence: 99%

Conscious sedation for balloon mitral valvotomy: A comparison of fentanyl versus sufentanil

Modak

Kane²

2017

Ann Card Anaesth

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Context:Analgesia and sedation are required for the comfort of patient and the cardiologist during balloon mitral valvotomy.Aims:In this study, efficacy of analgesia, sedation, and patient satisfaction with sufentanil was compared with fentanyl.Settings and Design:Single-centered, prospective single-blind study of sixty patients.Materials and Methods:Patients between 15 and 45 years of rheumatic mitral stenosis with valve area of 0.8–1 cm2 undergoing elective balloon mitral valvotomy, randomly divided to receive bolus injection fentanyl 1 mcg/kg (Group 1, n = 30) followed by infusion at 1 mcg/kg/h or bolus of injection sufentanil 0.1 mcg/kg (Group 2, n = 30) followed by continuous infusion at 0.1 mcg/h. Both the groups received injection midazolam bolus 0.02 mg/kg followed by infusion at 15 mcg/kg/h. Pain intensity (by visual analog score [VAS]), level of sedation (by Ramsay sedation scale), overall patient and operator's satisfaction, effect on cardiorespiratory parameters, and discharge score (by modified Aldrete score) were assessed.Statistical Analysis Used:Statistical analysis used Student's unpaired t-test and Chi-square test. P < 0.05 was considered statistically significant.Results:Mean number of bolus doses in fentanyl group was 0.9 versus 0.13 in sufentanil group (P < 0.01). The mean value of mean blood pressure in fentanyl group was 83.52 mmHg versus 88 mmHg in sufentanil group (P < 0.05), but the value was within normal range in both the groups. The mean VAS – patient's opinion in fentanyl group was 8.97 versus 9.53 in sufentanil group (P < 0.05). Mean discharge score in fentanyl group was 17.87 versus 18.23 in sufentanil group (P < 0.05). No statistically significant difference was found with respect to heart rate, respiratory rate, oxygen saturation, PaCO2 values, and anxiety scores.Conclusion:Sufentanil was found to be better with respect to analgesia, patient satisfaction, and recovery however not cost-effective for continuous infusion technique.

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“…Ancak sulfentanil karaciğerden metabolize olan uzun etkili bir opioiddir. Uzun süre-li infüzyonu ilacın birikmesine ve hastanın uyanmasında gecikmeye sebep olabilir (25). Cavaliere ve arkadaşları benzer sonuçları düşük doz remifentanil infüzyonu ile bildirmişlerdir (26).…”

Section: Sedasyon İçin Kullanılabilecek Ajanlarunclassified