No

Analgesic, Narcotic; General Anesthetic

Analgesic supplement in maintenance of balanced general anesthesia

C-II

C

Hypersensitivity to sufentanil or any component

Sufentanil can cause severely compromised respiratory depression; use with caution in patients with head injuries, hepatic or renal impairment or with pulmonary disease; sufentanil shares the toxic potential of opiate agonists, precaution of opiate agonist therapy should be observed; rapid I.V. infusion may result in skeletal muscle and chest wall rigidity impaired ventilation respiratory distress/arrest; inject slowly over 3-5 minutes; nondepolarizing skeletal muscle relaxant may be required

>10%:

Cardiovascular: Bradycardia, hypotension

Central nervous system: Drowsiness

Gastrointestinal: Nausea, vomiting

Respiratory: Respiratory depression

1% to 10%:

Cardiovascular: Cardiac arrhythmias, orthostatic hypotension

Central nervous system: Confusion, CNS depression

Gastrointestinal: Biliary tract spasm

Ocular: Blurred vision

<1%: Circulatory depression, convulsions, dysesthesia, paradoxical CNS excitation or delirium; mental depression, dizziness, rash, urticaria, itching, urinary tract spasm, laryngospasm, bronchospasm; cold, clammy skin; physical and psychological dependence with prolonged use

Naloxone 2 mg I.V. (0.01 mg/kg for children) with repeat administration as necessary up to a total of 10 mg; supportive care includes establishment of respiratory change; naloxone may be used to treat respiratory depression; muscular rigidity may also respond to opiate antagonist therapy or to neuromuscular blocking agents

CYP3A3/4 enzyme substrate

Binds with stereospecific receptors at many sites within the CNS, increases pain threshold, alters pain reception, inhibits ascending pain pathways; ultra short-acting narcotic

Onset of action: 1-3 minutes

Duration: Dose dependent

Metabolism: Primarily by the liver

Children <12 years: 10-25 mcg/kg with 100% O₂, maintenance: 25-50 mcg as needed

Adults: Dose should be based on body weight. Note: In obese patients (ie, >20% above ideal body weight), use lean body weight to determine dosage.

1-2 mcg/kg with N₂O/O₂ for endotracheal intubation; maintenance: 10-25 mcg as needed

2-8 mcg/kg with N₂O/O₂ more complicated major surgical procedures; maintenance: 10-50 mcg as needed

8-30 mcg/kg with 100% O₂ and muscle relaxant produces sleep; at doses greater than or equal to 8 mcg/kg maintains a deep level of anesthesia; maintenance: 10-50 mcg as needed

Parenteral: I.V.: Slow I.V. injection or by infusion

Drowsiness is common; may cause confusion; may rarely cause delirium or depression

Concurrent use with psychotropics may produce additive sedation

No information available to require special precautions

No effects or complications reported

Do not drive for 24 hours after receiving this medication

Patient may develop rebound respiratory depression postoperatively

Injection, as citrate: 50 mcg/mL (1 mL, 2 mL, 5 mL)

Bovill JG, Sebel PS, Blackburn CL, et al, "The Pharmacokinetics of Sufentanil in Surgical Patients," Anesthesiology, 1984, 61(5):502-6.

Bowdle TA, "Myoclonus Following Sufentanil Without EEG Seizure Activity," Anesthesiology, 1987, 67(4):593-5.

Guay J, Gaudreault P, Tang A, et al, "Pharmacokinetics of Sufentanil in Normal Children," Can J Anaesth, 1992, 39(1):14-20.

Gust R and Böhrer H, "Stiff-Man Syndrome Associated With Continuous Sufentanil Administration," Anaesthesia, 1995, 50(6):575.

Rosow CE, "Sufentanil Citrate: A New Opioid Analgesic for Use in Anaesthesia," Pharmacotherapy, 1984, 4(1):11-9.

Scholz J, Steinfath M, and Schulz M, "Clinical Pharmacokinetics of Alfentanil, Fentanyl, and Sufentanil. An Update," Clin Pharmacokinet, 1996, 31(4):275-92.

Seguin JH, Erenberg A, and Leff RD, "Safety and Efficacy of Sufentanil Therapy in the Ventilated Infant," Neonatal Netw, 1994, 13(4):37-40.