Actualización del uso de opiáceos en anestesiael sufentanilo

  1. García-Trancho, Andrea 1
  2. Peralta, Covadonga 1
  3. Martínez-Ruiz, Alberto 1
  1. 1 Servicio Vasco de Salud-Osakidetza. Organización Sanitaria Integrada Ezkerraldea-Enkarterri-Cruces Hospital Universitario Cruces. Servicio Anestesiología-Reanimación. Barakaldo, España
Revista:
Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

ISSN: 0304-4858 2173-2302

Año de publicación: 2023

Volumen: 120

Número: 2

Páginas: 105-112

Tipo: Artículo

Otras publicaciones en: Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

Resumen

El sufentanilo es un opiáceo sintético de 5 a 10 veces más potente que el Fentanilo. Sus propiedades farmacológicas específicas le confieren ciertas ventajas como la estabilidad hemodinámica o su rápido inicio de acción y de recuperación. Su uso en anestesia está ampliamente extendido tanto en anestesia general como regional y en analgosedación en unidades de críticos. A continuación, se presenta una revisión de las características farmacológicas del sufentanilo, sus usos actuales y sus ventajas o inconvenientes según la última evidencia disponible.

Referencias bibliográficas

  • Rosow C, Dershwitz M. Pharmacology of Opioid Analgesics. En: Longnecker DE, Brown DL, Newman MF, Zapol WM. eds. Anesthesiology, 2e. New York, NY: McGraw-Hill; 2012.
  • Monk JP, Beresford R, Ward A. Sufentanil. A review of its pharmacological properties and therapeutic use. Drugs. 1988; 36: 286-27.
  • Brownstein MJ. A brief history of opiates, opioid peptidesand opioid receptors. Proc Nat Acad Sci. 1993; 90: 5391-2.
  • Bailey PL, Streisand JB, East KA, East TF, Isern S, Hansen TW, et al. Differences in magnitude and duration of opioid-induced respiratory depression and analgesia with fentanyl and sufentanil. Anesth Analg. 1990; 70: 8-7.
  • Johnson KB, Healy A. The Clinical Pharmacology of Opioids. In: Johnson KB. eds. Clinical Pharmacology for Anesthesiology. New York, NY: Mc- Graw-Hill; 2015.
  • Lundeberg S1, Roelofse JA. Aspects of pharmacokinetics and pharmacodynamics of sufentanil in pediatric practice. Paediatr Anaesth. 2011; 21(3):274-9.
  • Ourahma S, Marchetti F, Clergue F. Perfusion peroperatoire de fentanyl ou de sufentanil: concentrations plasmatiques et modifications respiratoires postoperatoires. Ann Fr Anesth Reanim. 1993; 12: 357.
  • Raucoules-Aimé M, Kaidomar M, Levron JC, Le Moing JP, Goubaux B, Gugenheim J, Grimaud D. Hepatic disposition of alfentanil and sufentanil in patients undergoing orthotopic liver transplantation. Anesth Analg. 1997; 84(5):1019-24.
  • Bhavsar R, Sloth E, Folkersen L, Greisen JR, Jakobsen CJ. Sufentanil preserves hemodynamics and left ventricular function in patients with ischemic heart disease. Acta Anaesthesiol Scand. 2011; 55: 1002-7.
  • Hans P, Bonhomme V. Anesthetic management for neurosurgery in awake patients. Minerva Anestesiol. 2007; 73: 507-5.
  • Feltracco P, Carollo C, Barbieri S, Milevoj M, Pettenuzzo T, Gringeri E, et al. Pain Control After Liver Transplantation Surgery. Transplantation Proceedings. 2014; 46 (7): 2300-7
  • Djian MC, Blanchet B, Pesce F, Sermet A, Disdet M, Vazquez V, et al. Comparison of the Time to Extubation After Use of Remifentanil or Sufentanil in Combination with Propofol as Anesthesia in Adults Undergoing Nonemergency IntracranialSurgery: A Prospective, Randomized, Double-Blind Trial. Clinical Therapeutics. 2006; 28(4): p560-8
  • Martorano PP, Aloj F, Baietta S, Fiorelli A, Munari M, Paccagnella F, et al. Sufentanil-propofol vs remifentanil-propofol during total intravenous anesthesia for neurosurgery. A multicentre study. Minerva Anestesiol. 2008;74(6):233-43.
  • Engoren M, Luther G, Fenn-Buderer N. A comparison of fentanyl, sufentanil, and remifentanil for fast-track cardiac anesthesia. Anesth Analg. 2001; 93: 859-5.
  • Constant I, Louvet N, Guye ML, Sabourdin N. General anaesthesia in children: a French survey of practices. Ann Fr Anesth Reanim. 2012; 31(9):709-23
  • Durrmeyer X, Dahan S, Delorme P, Blary S, Dassieu G, Caeymaex L, et al. Assessment of atropine-sufentanil-atracurium anaesthesia for endotracheal intubation: an observational study in very premature infants. BMC Pediatr. 2014; 14 :120.
  • Rakanrattana U, Suksompong S: Comparison of sufentanil and fentanyl for surgical repair of congenital cardiac defects. J Med Assoc Thi. 2002; 85 (Suppl. 3): 807-7
  • Glenski JA, Friesen RH, Hassanein RS, Henry DBJ. Comparison of the hemodynamic and echocardiographic effects of sufentanil, fentanyl, isoflurane, and halothane for pediatric cardiovascular surgery. Cardiothorac Anesth. 1988 ; 2(2):147-8.
  • Li X, Zhang Y, Zhou M, Xia Q, Li W, Lu Q. The effect of small dose sufentanil on emergence agitation in preschool children following sevoflurane anesthesia for elective repair of unilateral inguinal hernia. Saudi Med J. 2013; 34(1):40-5
  • Hitt JM, Corcoran T, Michienzi K, Creighton P, Heard C. An evaluation of intranasal sufentanil and dexmedetomidine for pediatric dental sedation. Pharmaceutics. 201; 21;6(1):175-9.
  • Nielsen BN, Friis SM, Rømsing J, Schmiegelow K, Anderson BJ, Ferreirós N et al. Intranasal sufentanil/ ketamine analgesia in children. Paediatr Anaesth. 2014; 24(2):170-10.
  • Li H, Li Y, He R. Sparing effects of sufentanil on epidural ropivacaine in elderly patients undergoing transurethral resection of prostate surgery. Yonsei medical journal. 2015. 56 (3): P832-7
  • Hong JY, Yang SC, Yi J, Kil HK. Epidural ropivacaine and sufentanil and the perioperative stress response after radical retropubic prostatectomy. Acta Anaesthesiol Scand. 2011; 55: 282-7
  • Cosmo G, Congedo E, LaiC, Sgreccia M, Amato A, Beccia G, et al: Ropivacaine vs. levobupivacaine combined with sufentanil for epidural analgesia after lung surgery. Eur J Anaesthesiol 2008; 25: 1020-5.
  • SendasguptaC, MakhijaN, Kiran U, ChoudharySK, Lakshmy R, Das SN: Caudal epidural sufentanil and bupivacaine decreases stress response in paediatric cardiac surgery.Ann Card Anaesth 2009; 12: 27-33.
  • Cho JE, Kim JY, Kim JE, Chun DH, Jun NH, Kil HK. Epidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in children. Acta Anaesthesiol Scand 2008; 52:1360-3
  • Sitsen E, Poorten F, Alphen W, Rose L, Dahan A, et al: Postoperative epidural analgesia after total knee arthroplasty with sufentanil 1 mg/ml combined with ropivacaine 0.2%, ropivacaine 0.125%, or levobupivacaine 0.125%: a randomized, double-blind comparison. Reg Anesth Pain Med. 2007; 32: 475-5.
  • Bhargava S, Tamaskar A, Chakravarty N, Shende S, Shidhaye RV. Comparative study of thoracic epidural fentanyl with sufentanil for postoperative pain relief in thoracic surgery. Anaesthesia, Pain and Intensive Care. 2015. 18(3). Pages 260-4
  • Popping DM, Elia N, Marret E, Wenk M, Tramer MR. Opioids added to local anesthetics for single intrathecal anaesthesia. Eur J Anesthesiol. 2011; 28 (Suppl. 48): 6-4
  • Motiani P, Chaudhary S, Bahl N, Sethi AK: Intrathecal sufentanil versus fentanyl for lower limb surgeries – a randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2010; 26: 507-6.
  • Azimaraghi O, Marashi SM, Khazaei N, Pourhassan S, Movafegh A. The effect of adding sufentanil to 0.5% hyperbaric bupivacaine on duration of brachial plexus blockade in chronic opium abusers: A randomized clinical trial. Anesthesiology and Pain Medicine . 2015; 5(3)
  • Antonucci S. Adiuvants in the axillary brachial plexus blockade. Comparison between clonidine, sufentanil and tramadol. Minerva Anestesiol. 2001; 67(1-2):23-7.
  • Weller RS, Butterworth J. Opioids as local anesthetic adjuvants for peripheral nerve block. Techniques in Regional Anesthesia and Pain Management. 2004; 8 (3): 123–5.
  • Wang K, Cao L, Deng Q, Sun LQ, Gu TY, Song J. The effects of epidural/spinal opioids in labour analgesia on neonatal outcomes: a meta-analysis of randomized controlled trials. Anaesth. 2014; 61(8):695-14.
  • Chen X, Qian X, Fu F, Lu H, Bein B. Intrathecal sufentanil decreases the median effective dose (ED50) of intrathecal hyperbaric ropivacaine for caesarean delivery. Acta Anaesthesiol Scand. 2010; 54: 284-6
  • Bauchat J, Wong CA. Neuraxial Labor Analgesia and Effect on Labor. In: Santos AC, Epstein JN, Chaudhuri K. eds. Obstetric Anesthesia. New York, NY: McGraw-Hill; 2015.
  • Toledo P. Anesthesia for Cesarean Section and Postoperative Analgesia. In: Santos AC, Epstein JN, Chaudhuri K. eds. Obstetric Anesthesia. New York, NY: McGraw-Hill; 2015
  • Kröll W, List WF. Is sufentanil suitable for longterm sedation of a critically ill patient. Anaesthesist. 1992; 41(5):271-5
  • Costa MG, Chiarandini P, Della Rocca G. Sedation in the critically ill patient. Transplant Proc. 2006;38(3):803-4.
  • Wappler F, Scholz J, Prause A, Möllenberg O, Bause H, Schulte am Esch J. Level concept of analgesic dosing in intensive care medicine with sufentanil. Anasthesiol Intensivmed Notfallmed Schmerzther. 1998 Jan;33(1):8-13
  • Yang H, Sun R, Chang Y, Fu Y, Li B, Qin B, et al. A multicenter randomized controlled trial of sufentanil for analgesia/sedation in patients in intensive care unit. Chinese Critical Care Medicine. 2014; 26 (2); 94-6.
  • The SRLF Trial Group. Sedation in French intensive care units: a survey of clinical practice. Annals of Intensive Care.2013, 3:24????
  • Soltész S, Biedler A, Silomon M, Schopflin I, Molter GP. Recovery after remifentail and sufentanil for analgesia and sedation of mechanically ventilated patients after trauma or major surgery. Br J Anaesth. 2001; 86: 763-8.
  • Hoshijima H, Takeuchi R, Kuratani N, Nishizawa S, Denawa Y, Shiga T, Nagasaka HJ . Incidence of postoperative shivering comparing remifentanil with other opioids: a meta-analysis. Clin Anesth. 2015.