A Comparison of Morphine, Fentanyl, and Sufentanil Anesthesia for Cardiac Surgery

Sanford, Theodore J.; Smith, N. Ty; Dec-Silver, H.; Harrison, Walter K.

doi:10.1213/00000539-198603000-00007

Cited by 103 publications

(22 citation statements)

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“…Fentanyl is less likely to cause hemodynamic instability and a decrease in systemic vascular resistance, which would help alleviate the concerns of potentially exacerbating the hypoxic spell. 3,4 There are reports, however, of rigid chest associated with the rapid administration of IV fentanyl, which decreases chest wall compliance and interferes with spontaneous ventilation. [19][20][21][22] To date, there have been no reports of rigid chest associated with IN fentanyl administration in children or adults.…”

Section: Discussionmentioning

confidence: 99%

“…There is also the concern that morphine may exacerbate a hypoxic spell because of its potential to decrease systemic vascular resistance. 3,4 Intranasal (IN) fentanyl is an alternative strategy, combining a painless and effective route of administration with the use of an opioid less likely to cause hemodynamic instability than morphine. [3][4][5][6] We describe the first case, to our knowledge, of administering IN fentanyl to successfully treat a child experiencing a TOF hypoxic spell.…”

Section: Abbreviationsmentioning

confidence: 99%

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Treatment of Tetralogy of Fallot Hypoxic Spell With Intranasal Fentanyl

et al. 2014

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We present the case of a 3-month-old girl who had unrepaired Tetralogy of Fallot who presented to the emergency department with an acute hypoxic episode. The patient was hyperpneic and cyanotic, with an initial oxygen saturation of 56%. She did not respond to knee-to-chest positioning. A single dose of intranasal fentanyl was administered with subsequent resolution of her symptoms and improvement of her oxygen saturation to 78% within 10 minutes. To our knowledge, this is the first report of the successful treatment of a hypoxic episode of Tetralogy of Fallot using intranasal fentanyl. Dr Tsze conceptualized the case report, wrote the manuscript, and critically reviewed and revised the manuscript; Dr Vitberg assisted with data acquisition and critically reviewed and revised the manuscript; Dr Berezow provided substantial intellectual input and critically reviewed and revised the manuscript; Dr Starc provided substantial intellectual input and critically reviewed and revised the manuscript; Dr Dayan provided substantial intellectual input and critically reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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Section: Discussionmentioning

confidence: 99%

Section: Abbreviationsmentioning

confidence: 99%

Treatment of Tetralogy of Fallot Hypoxic Spell With Intranasal Fentanyl

et al. 2014

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“…Our findings agree with those of mast investigators, a'6"7 but are substantially at variance with those of Sanford er al. 5 who reported extubation 22.1hr and 14.8 hr after induction with fentanyl 95.4 ~g.kg -1 and sufentanil 18.9 Ixg-kg -~ respectively. Sanford et at.…”

Section: Discussionmentioning

confidence: 99%

A randomized doubleblind comparison of fentanyl and sufentanil anaesthesia for coronary artery surgery

et al. 1987

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“…The general theme in the "fast-track" era (rapid progress through the ICU and hospital) is to minimize use of long-acting agents during the maintenance phase of anesthesia (13,14). With coronary obstruction, myocardial oxygen demand must be minimized.…”

Section: Effect Of Intraoperative Events and Managementmentioning

confidence: 99%