Withdrawal following sufentanil/propofol and sufentanil/midazolam

Abstract

The endorphinergic system is suppressed when a potent exogenous opioid like sufentanil is given over a long period of time. Following sedation, abstinence symptoms seem to be related to postinhibitory increased endorphin synthesis. This is mostly seen in the combination of sufentanil/midazolam. In addition, an increase in the amplitude of the sensory-evoked potential suggests a postinhibitory excitatory state within the nociceptive system.

Responses to noxious stimuli in sedated mechanically ventilated adults

“…31, 32 Blood samples were drawn after a 30 minute period without stimulation (i.e., no physical stimulation and the subject appeared restful) and within 1 minute after ETT suctioning. Each three ml sample was collected in a tube containing EDTA and Trasylol and immediately placed on ice; plasma was separated by refrigerated centrifugation, and frozen at −70° C within one hour of collection.…”

Withdrawal symptoms in children after long-term administration of sedatives and/or analgesics: a literature review. “Assessment remains troublesome”

“…Benzodiazepine withdrawal is also reported in adult psychiatric and drug-addicted populations [8][9][10]. Two retrospective and one prospective randomized controlled trial have been reported on opioid and/or benzodiazepine withdrawal after long-term administration of analgesics or sedatives in the adult ICU setting [11][12][13]. The reported incidence of withdrawal syndrome in adult ICU patients ranges from 32.1% (9/28) to 100% [11,12].…”