Pre-Induction of Anesthesia in Pediatric Patients with Nasally Administered Sufentanil

Henderson, Jane; Brodsky, Drew A.; Fisher, Dennis M.; Brett, Claire M.; Hertzka, Robert E.

doi:10.1097/00132586-198810000-00051

Cited by 22 publications

(11 citation statements)

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“…In addition, intranasal drug administration does not require sterile technique, clinical skills required for placing intravenous catheters or injecting medications, and it is immediately and readily available in almost all patients. Finally, for a number of parenteral medications, the rate and extent of absorption and plasma concentration vs. time profiles when the drug is delivered intranasally are comparable to those obtained by intravenous administration (31)(32)(33)(34)(35).…”

Section: Numbers Of Patients Who Presented With Altered Mental Statmentioning

confidence: 80%

Efficacy of intranasal naloxone as a needleless alternative for treatment of opioid overdose in the prehospital setting

Barton

Colwell

Wolfe

et al. 2005

The Journal of Emergency Medicine

123

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Section: Numbers Of Patients Who Presented With Altered Mental Statmentioning

confidence: 80%

Efficacy of intranasal naloxone as a needleless alternative for treatment of opioid overdose in the prehospital setting

Barton

Colwell

Wolfe

et al. 2005

The Journal of Emergency Medicine

123

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“…However, most studies have evaluated its use for premedication or sedation using the IN route, and not for postoperative analgesia. [7][8][9][10][11] Nasal administration of drugs must be done using small volumes to avoid irritation of nasal mucosal membranes. The maximum volume to avoid run-off into the pharynx by a single administration in one nostril in adults is 150 µL.…”

Section: Resultsmentioning

confidence: 99%

Intranasal sufentanil is effective for postoperative analgesia in adults

Mathieu¹,

Cnudde²,

Engelman³

et al. 2006

Can J Anesth/J Can Anesth

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Purposes:The aim of this prospective, randomized, doubleblind study was to compare two doses of intranasal sufentanil for postoperative analgesia, titrated according to individual requirements based upon a numeric rating scale (NRS) from 0 to 10 for pain.Methods: Forty patients, American Society of Anesthesiologists physical status I-II, scheduled for herniorrhaphy or hemorrhoidectomy under general anesthesia, were included when postoperative NRS was > 3. Nurses used a nasal puff device delivering a constant volume. Patients were randomized into two groups: Group A patients received a dose of 0.025 µg·kg -1 /puff, Group B patients a dose of 0.05 µg·kg -1 /puff. Puffs were administered as often as needed to obtain NRS ≤ 3, with an interval time of five minutes. Hemodynamic, respiratory measures and sedation were recorded every five minutes. Results:The probability of persistence of pain in Group B was consistently lower than in Group A. After 20 min, 20% of the patients had a NRS score > 3 in Group B, as opposed to 60% in Group A. At 60 min, no patient had a NRS > 3 in Group B, whereas there was a probability of 20% to record a NRS > 3 for Group A. Hemodynamic, respiratory parameters and sedation remained stable with no intergroup differences.Conclusions: Nasal administration of 0.050 µg·kg -1 /puff sufentanil allowed a NRS < 4 to be attained within one hour in all patients, with efficacy achieved after 20 min. These findings suggest that the intranasal route is an effective mode of sufentanil administration for immediate postoperative analgesia in adult patients. Objectif

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“…Henderson et al. (25) examined eighty children aged 6 months to 7 years. The children were randomized to receive sufentanil (1.5, 3 or 4.5 μg·kg −1 ) or placebo.…”

Section: Pharmacokineticsmentioning

confidence: 99%

Aspects of pharmacokinetics and pharmacodynamics of sufentanil in pediatric practice

Lundeberg

Roelofse

2010

Pediatric Anesthesia

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Sufentanil is a potent synthetic opioid. Like other opioids, sufentanil creates a stable hemodynamic environment in cardiovascularly compromised pediatric patients. Clearance, expressed as per kilogram, is increased in children compared to adults. The P450 CYP3A4 enzyme is responsible for the major metabolic N-dealkylation pathway. Enzyme activity is reduced in neonates but the maturation of sufentanil clearance is not described. The free active fraction is affected by age because of the reduced α(1) -acid glycoprotein plasma concentrations in neonates. Intranasal administration of sufentanil is a possible option for premedication, procedural sedation and analgesia in children, as this option has been found to be safe and effective. Studies concerning the pharmacokinetics and dynamics of sufentanil administered as a bolus or continuous infusion in children are few.

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Pre-Induction of Anesthesia in Pediatric Patients with Nasally Administered Sufentanil

Cited by 22 publications

References 0 publications

Efficacy of intranasal naloxone as a needleless alternative for treatment of opioid overdose in the prehospital setting

Efficacy of intranasal naloxone as a needleless alternative for treatment of opioid overdose in the prehospital setting

Intranasal sufentanil is effective for postoperative analgesia in adults

Aspects of pharmacokinetics and pharmacodynamics of sufentanil in pediatric practice

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