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IV: 1-3 min IN: < 5 min Neuraxial: 4-10 min
IV: 3-5 min IN: 10 min Neuraxial: < 30 min
IV: 20-45 min IM: 2-4 hrs Neuraxial: 4-6 hrs
Potency - 5-10 times more potent than Fentanyl Context-sensitive half-time (CSHT) - for continuous infusions, Sufenta INITIALLY has a longer CSHT than Fentanyl and a shorter half-time than Alfentanil. After a short period of infusion, this reverses - Fentanyl and Alfentanil become significantly more prolonged. Side effects - may cause bradycardia, hypotension, respiratory depression, and chest muscle rigidity (with rapid administration). There's very little affect on cerebral blood flow, CMRO2, and may lower intracranial pressure (ICP) and cerebral perfusion pressures (CPP) OB - Readily crosses the placenta, so use extreme caution in parturients Dosing - use ideal body weight in the obese. Consider reducing doses in the elderly hypovolemic, and opioid naive. Common mixtures - 5 mcg/ml and 10 mcg/ml Infusion recommendations - discontinue drip 35-45 minutes prior to emergence. Respiratory depression and LOC issues are common if not discontinued with enough time before emergence.
DL blunting: 0.1-0.3 mcg/kg Sole-agent Induction: 2-10 mcg/kg
Common dose: 0.2 mcg/kg/hr Textbook: 0.15 - 0.5 mcg/kg/hr Textbook: 0.005 - 0.015 mcg/kg/min MAX: 1 mcg/kg/hr (total infusion + bolus doses)
10 - 50 mcg - this can be up to 3 administrations (1 hour apart). Each dose should provide 1-2 hours of analgesia
10-50 mcg/hr
5-10 mcg. This gives ~ 4-6 hours of analgesia
Opioid agonist
Hepatic
Adult: 0.5–1 mcg/kg every 3–5 min, titrated to respiratory rate (in a 10 ml syringe, draw up the 1 ml 0.4 mg/ml with 9 ml of saline. That makes 40 mcg/ml) This drug will wear off well before standard opioids, so follow with IM naloxone (1-2 mcg/kg) or an infusion (4-5 mcg/kg/hr)
