Sufentanil


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Adjunct to anesth w/ nitrous oxide and oxygen For surgical procedures ≤8 hr: Up to 75% of the dose to be given before intubation followed by additional doses of 10-50 mcg as needed during surgery. Total dose: ≤1 mcg/kg/hr. As primary anaesthetic Given w/ 100% oxygen: Initial: 8-30 mcg/kg. Maintenance: Additional doses of 0.5-10 mcg/kg may be given if needed. Max (total dose): 30 mcg/kg. Post-op pain Initial: 30-60 mcg. Additional doses of up to 25 mcg may be given at intervals of ≥1 hr if needed. Epidural Pain relief during labour and delivery W/ bupivacaine: 10-15 mcg w/ or w/o epinephrine. May repeat dose twice at intervals of ≥1 hr till delivery. Max (total dose): 30 mcg.
Dosage Details
Epidural
Pain relief during labour and delivery
Adult: 10-15 mcg plus 10 ml bupivacaine 0.125% with or without epinephrine. May repeat dose twice at intervals of at least 1 hr until delivery. Max (total dose): 30 mcg.

Intravenous
Adjunct to anaesthesia with nitrous oxide and oxygen
Adult: For surgical procedures ≤8 hr: Up to 75% of the dose to be given before intubation followed by additional doses of 10-50 mcg as needed during surgery; dose may also be given by continuous or intermittent infusion. Total dose should not exceed 1 mcg/kg/hr.
Child: Given with 100% oxygen, 10-25 mcg/kg as initial dose; maintenance doses: 25-50 mcg as necessary.
Elderly: Dosage reduction may be required.

Intravenous
Postoperative pain
Adult: Initially, 30-60 mcg. Additional doses of up to 25 mcg may be given at intervals of at least 1 hr if necessary.
Elderly: Dosage reduction may be required.

Intravenous
Primary anaesthetic
Adult: Given with 100% oxygen, initially, 8-30 mcg/kg. For maintenance, additional doses of 0.5-10 mcg/kg may be given as necessary. Max (total dose): 30 mcg/kg.
Child: Initially, 10-25 mcg/kg, to be used with 100% oxygen. Maintenance doses of up to 25-50 mcg.
Elderly: Dosage reduction may be required.
Contraindications
Acute respiratory depression, acute alcoholism, hypersensitivity, comatose patients.
Special Precautions
Hypotension; hypothyroidism; asthma, pulmonary disease, decreased respiratory reserve; prostatic hypertrophy; renal or hepatic impairment; pregnancy and lactation; elderly, obese and debilitated patients; convulsive disorders. Monitor vital signs during admin of sufentanil. Head injuries, phaeochromocytoma, gradual withdrawal is advised. Increased risk of bradycardia and hypotension in patients on chronic calcium channel and β-blocker treatment.
Adverse Reactions
GI disturbances. Difficulty with micturition, ureteric or biliary spasm; dry mouth; sweating; headache, facial flushing; vertigo; bradycardia, tachycardia, palpitations, postural hypotension; hypothermia; hallucinations; dysphoria; mood changes; dependence; miosis; decreased libido or potency; rashes, urticaria and pruritus. Respiratory depression and hypotension may occur with larger doses.
Epidural/IV/Parenteral: C
Overdosage
The most serious effect of overdose is respiratory depression. IV admin of an opioid antagonist such as naloxone may be used as an antidote to manage respiratory depression. Oxygen may be admin. Control or assist ventilation as indicated for hypoventilation or apnoea. Maintain a patent airway. IV fluids, vasopressors and other symptomatic treatment may be employed.
Drug Interactions
Benzodiazepines, antipsychotics, TCAs, anxiolytics and hypnotics may enhance sedative effects. Cimetidine may increase plasma concentrations of sufentanil. May reduce serum concentrations of ciprofloxacin.
Potentially Fatal: Possible CNS excitation or depression may occur when given with MAOIs or within 14 days of stopping MAOI treatment.
Action
Description: Sufentanil is a phenylpiperidine-derivative opiate agonist related to fentanyl. It is used as an analgesic adjunct in anaesthesia and as a primary anaesthetic drug in procedures requiring assisted ventilation.
Onset: Usually, 1.2-3 min after IV admin; within 10 min (10-15 mcg epidural inj plus 0.125% bupivacaine with epinephrine 1:200,000).
Duration: 1-2 hr (10-15 mcg epidural Inj plus 0.125% bupivacaine with epinephrine 1:200,000).
Pharmacokinetics:
Distribution: About 90% bound to plasma proteins.
Metabolism: Metabolised in the liver and small intestine by N-dealkylation and O-demethylation.
Excretion: Terminal elimination half-life: about 2.5 hr. Metabolites are excreted in the urine.
Disclaimer: This information is independently developed by MIMS based on Sufentanil from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in