| SUFENTANIL CITRATE
Classifications: narcotic (opiate) agonist analgesic; general anesthetic; Therapeutic: narcotic analgesic
Pregnancy Category: C
Controlled Substance: Schedule II
50 mcg/mL injection
Synthetic opioid related to fentanyl with similar pharmacologic actions, but about 7 times more potent. Onset of action
and recovery from anesthesia occur more rapidly with sufentanil than with fentanyl. In common with other opiate agonists,
sufentanil can cause respiratory depression and suppression of cough reflex.
Effective agent for analgesia as a supplement or a primary anesthesia.
Analgesic supplement in maintenance of balanced general anesthesia and also as a primary anesthetic.
Hypersensitivity to opiate agonists; pregnancy (category C).
Pulmonary disease, reduced respiratory reserve; COPD; cardiac disease; increased intracranial pressure; seizure disorders;
impaired liver or kidney function; GI disease; lactation.
Route & Dosage
|Adjunct to General Anesthesia
Adult: IV 18 mcg/kg, depending on duration of surgery, may give additional doses of 1050 mcg if needed
As Primary Anesthetic
Adult: IV 130 mcg/kg administered with 100% oxygen and a muscle relaxant, may give additional doses of 1050 mcg if
Child (<12 y): IV 1025 mcg/kg administered with 100% oxygen and a muscle relaxant, may give additional doses of 2550 mcg up
to 12 mcg/kg/dose if needed
Use lean body weight.
- Administer only by qualified personnel, specifically trained in the use of IV anesthesia and in the management of respiratory
- Have available a narcotic antagonist (e.g., naloxone) to reverse respiratory depression.
PREPARE: Direct: Examine solution for particulate matter and discoloration (solution should be clear) before administration. Give undiluted.
ADMINISTER: Direct: Give a bolus dose over 35 sec. Epidural: Give by slow injection and closely monitor respirations after each injection.
INCOMPATIBILITIES Solution/additive: Diazepam, lorazepam, phenobarbital, phenytoin, sodium bicarbonate, sodium chloride. Y-site: Lorazepam, phenytoin, thiopental.
- Store at 15°30° C (59°86° F) unless otherwise directed; protect from light.
Adverse Effects (≥1%)CV:
Bradycardia, tachycardia, hypotension, hypertension, arrhythmias. GI:
Nausea, vomiting, constipation
Bronchospasm, respiratory depression, apnea. Body as a Whole: Skeletal muscle rigidity (especially of trunk),
spasms of sphincter of Oddi, urinary retention.
InteractionsDrug: beta-adrenergic antagonists
increase incidence of bradycardia; alcohol
and other cns depressants
such as barbiturates
and inhalation general anesthetics
add to CNS depression; cimetidine
increases risk of respiratory depression
1.53 min. Duration:
40 min. Distribution:
Crosses bloodbrain barrier. Metabolism:
In liver (CYP3A4) and small intestine. Elimination:
In urine and feces. Half-Life:
Assessment & Drug Effects
- Monitor vital signs. Observe for skeletal muscle rigidity, especially of chest wall, and respiratory depression, particularly
in older adults, and in patients who are obese, debilitated, or who have received high doses.
- Bear in mind that if naloxone is given to reverse respiratory depression, the duration of sufentanil-induced respiratory
depression may exceed the duration of naloxone.
Patient & Family Education
- Avoid activities which require mental alertness for at least 24 h after receiving this drug.