Alfentanil in Anesthesia and Analgesia

Reitz, Jeffrey A.

doi:10.1177/106002808602000501

Cited by 17 publications

(8 citation statements)

References 45 publications

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“…Alfentanil, sufentanil, and remifentanil are potent synthetic and short-acting opioid drugs of the anilidopiperidine family whose use has increased during the past three decades [29–32]. Alfentanil, a derivative of fentanyl, has a quicker onset and shorter duration of action than fentanyl and its vagomimetic properties are more intense than those of fentanyl and sufentanil.…”

Section: Protocols For Hypotensive Anesthesiamentioning

confidence: 99%

Hypotensive Anesthesia versus Normotensive Anesthesia during Major Maxillofacial Surgery: A Review of the Literature

Barák

Leiser

El-Naaj

2015

The Scientific World Journal

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Steady blood pressure within normal limits during surgery is one of the markers of the ideal and skillful anesthesia. Yet, reduced blood pressure is advantageous in some settings because it can contribute to a reduction in overall blood loss and improve the surgical field conditions. Controlled hypotension during anesthesia or hypotensive anesthesia is often used in major maxillofacial operations. Since hypotensive anesthesia carries the risk of hypoperfusion to important organs and tissues, mainly the brain, heart, and kidneys, it cannot be applied safely in all patients. In this paper we review the medical literature regarding hypotensive anesthesia during major maxillofacial surgery, the means to achieve it, and the risks and benefits of this technique, in comparison to normotensive anesthesia.

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Section: Protocols For Hypotensive Anesthesiamentioning

confidence: 99%

Hypotensive Anesthesia versus Normotensive Anesthesia during Major Maxillofacial Surgery: A Review of the Literature

Barák

Leiser

El-Naaj

2015

The Scientific World Journal

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“…1982;Ferrier 1985} suggests that the total body clearance of alfentanil could be influenced by changes in both hepatic blood flow and intrinsic clearance (Reitz 1986). In contrast to fentanyl, the duration of effect of a single dose of alfentanil is relatively more dependent on total body clearance than on redistribution to tissues.…”

Section: Clinical Pharmacology Of Alfentanilmentioning

confidence: 99%

“…These differences may be responsible for the lower clearance seen with alfentanil. Binding to ai-acid glycoprotein accounts for the majority of alfentanil plasma protein binding (Meistelman et al 1985;Reitz 1986).…”

Section: Plasma Protein Bindingmentioning

confidence: 99%

Alfentanil Infusions in Patients Requiring Intensive Care

Bodenham

Park

1988

Clinical Pharmacokinetics

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Alfentanil is a short acting opioid that has an established place in anaesthesia. Its predictable pharmacokinetics and pharmacodynamics, particularly its rapid termination of effect and haemodynamic stability, have led to its use by continuous intravenous infusion both during anaesthesia and more recently in critically ill patients. Fine control of a potent analgesic that has respiratory depressant and antitussive properties would be particularly advantageous in this group, offering patients an improvement in comfort without increasing the risk of oversedation. Pharmacokinetic studies of alfentanil have demonstrated wide interindividual variations. This may be due to a wide variety of factors including age, obesity, hepatic dysfunction, changes in regional haemodynamics, sex, and alterations in plasma protein binding ability and concentration. The importance of pharmacogenetic differences and tolerance to alfentanil remains to be elucidated. Renal disease does not appear to significantly alter the pharmacokinetics of this agent, which may make it particularly useful in this situation. Since alfentanil does not depress conscious level or produce anxiolysis, additional agents such as a benzodiazepine will be necessary to provide adequate sedation. The difficulties in accurately predicting the response of an individual critically ill patient necessitate careful and continuous dose titration of alfentanil according to the clinical response.

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“…Fospropofol may provide an improved safety and efficacy profile and may be clinically useful when rapid onset of action is not necessary and a more prolonged effect is desired [4,11]. Alfentanil is a potent, but short-acting synthetic opioid analgesic drug that targets the m-opioid receptors [12]. Compared with fentanyl, alfentanil produces earlier peak analgesic effect, faster recovery of consciousness and a more pronounced narcotic effect with no increase in adverse effects.…”

mentioning

confidence: 99%