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Sufentanil

    DEA Class; Rx

    Common Brand Names; Sufenta

    • Opioid Analgesics; 
    • Synthetic, Opioids

    May open K+ channels and inhibit Ca++ channels, causing an increase in pain threshold and alteration in pain perception. It also inhibits ascending pain pathways

    Indicated for Anesthesia

    Hypersensitivity to drug or excipients

    Nausea

    Vomiting

    Constipation

    Sweating, flushing, warmness of the face/neck/upper thorax

    Pruritus, urticaria

    Bradycardia

    Dizziness

    Visual disturbances

    Mentalclouding/depression

    Sedation

    Coma

    Euphoria/Dysphoria

    Weakness

    Faintness

    Agitation

    Restlessness

    Nervousness

    Seizures

    Use caution in bradycardia, compromised cardiac reserve, head injury, hypothyroidism, increased intracranial pressure, intracranial lesions, renal function impairment, respiratory impairment

    In patients who may be susceptible to intracranial effects of CO2 retention (eg, those with evidence of increased intracranial pressure or brain tumors), therapy may reduce respiratory drive, and resultant CO2 retention can further increase intracranial pressure; monitor such patients for signs of sedation and respiratory depression, particularly when initiating therapy; opioids may obscure clinical course in a patient with a head injury; avoid the use in patients with impaired consciousness or coma

    May cause spasm of sphincter of Oddi; opioids may cause increases in serum amylase; monitor patients with biliary tract disease, including acute pancreatitis, for worsening symptoms

    Therapy may increase frequency of seizures in patients with seizure disorders and in other clinical settings associated with seizures; monitor patients for worsened seizure control during therapy

    Therapy may impair mental or physical abilities needed to perform potentially hazardous activities such as driving a car or operating machinery; warn patients not to drive or operate dangerous machinery after receiving therapy

    Life-threatening respiratory depression is more likely to occur in elderly, cachectic, or debilitated patients because they may have altered pharmacokinetics or altered clearance compared to younger, healthier patients; monitor closely

    Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome; available data in pregnant women are insufficient to inform a drug-associated risk for major birth defects and miscarriage

    The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy; capsules and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition

    Adults

    Anesthesia

    Induction/intubation: 1-2 mcg/kg IV, THEN 10-50 mcg IV PRN  

    General Anesthesia: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRN

    Should be administered with 100% O2, with ventilatory support

    Dose should be calculated based on ideal body weight

    Other Indications & Uses

    Low dose: Analgesia in intubation, ventilation (adjunct)

    High dose: Primary anesthesia induction & maint

    Epidural analgesia (with bupivacaine)

    Pediatric

    Anesthesia

    <2 years: Safety and efficacy not established

    2-12 years: 10-25 mcg/kg IV increments

    >12 years: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRN

    Geriatric

    Induction/intubation: 1-2 mcg/kg IV, THEN 10-50 mcg IV PRN  

    General Anesthesia: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRN

    Should be administered with 100% O2, with ventilatory support

    Dose should be calculated based on ideal body weight

    Sufentanil Citrate

    injectable solution: Schedule II

    • 0.05mg/mL